细胞外容积分数对62例不同病理类型肺癌的诊断价值

Diagnostic value of extracellular volume fraction in 62 cases of different pathological types of lung cancer

目的探讨细胞外容积分数(ECV)对不同病理类型肺癌的诊断价值。方法对62例肺癌患者进行纵向弛豫时间定量(T1 mapping)扫描,在增强前后的T1 mapping图像上勾画感兴趣区,测量病灶、主动脉血池强化前后的T1值,收集患者的红细胞压积,计算ECV;运用单因素方差分析检验不同病理类型肺癌ECV的差异,构建受试者工作特征曲线分析其诊断价值,并计算灵敏度、特异度及准确率。结果共纳入62例患者,其中小细胞肺癌13例,非小细胞肺癌49例(包括33例腺癌、16例鳞癌)。小细胞肺癌与非小细胞肺癌的ECV平均值分别为(13.79±5.93)%和(27.17±6.59)%,非小细胞肺癌高于小细胞肺癌,截断值为18.97%,敏感度、特异度及准确率分别为89.8%、92.3%、90.3%;腺癌及鳞癌的ECV平均值分别为(24.21±4.92)%、(33.28±5.32)%,差异有统计学意义(P<0.001);鳞癌ECV值高于腺癌,截断值为29.11%,敏感度、特异度及准确率分别为84.8%、81.2%、83.7%。结论ECV可以定量分析肺癌的组织特征,可以通过测量ECV鉴别肺癌的病理类型,具有较高的灵敏度、特异度及准确率。

Objective To evaluate the differential diagnostic value of extracellular volume fraction(ECV)in the different pathological types of lung cancer.Methods Sixty-two patients with lung cancer were performed T1 mapping sequence in this prospective study.Areas of interest were delineated on T1 mapping images.The T1 value of lesions and aortic blood pool were measured in the T1 mapping images before and after enhancement.Hematocrit was collected to calculate the ECV.One-way ANOVA was used to compare the differences among the different pathological types of lung cancer.The receiver operating characteristic curve was constructed to analyze its diagnostic value.The sensitivity,specificity and accuracy were calculated.Results A total of 62 patients were included,including 13 cases of small cell lung cancer and 49 cases of non-small cell lung cancer(including 33 cases of adenocarcinoma and 16 cases of squamous cell carcinoma).The mean ECV of small cell lung cancer and non-small cell lung cancer were(13.79±5.93)%and(27.17±6.59)%,respectively.The ECV value of non-small cell lung cancer was higher than small cell lung cancer,and the cut-off value was 18.97%.The sensitivity,specificity and accuracy were 89.8%,92.3%,and 90.3%,respectively.The average ECV values of adenocarcinoma and squamous cell carcinoma were(24.21±4.92)%and(33.28±5.32)%,respectively,and the difference was statistically significant(P<0.001).The ECV value of carcinoma was higher than adenocarcinoma,the cut-off value was 29.11%,and the sensitivity,specificity and accuracy were 84.8%,81.2%and 83.7%,respectively.Conclusion ECV can quantitatively analyze the tissue characteristics of lung cancer,and identify the pathological type of lung cancer,with good sensitivity,specificity and accuracy.