CT灌注成像参数与非小细胞肺癌EGFR基因突变及化疗敏感性的关系分析

Relationship between CT Perfusion Imaging Parameters and EGFR Gene Mutation and Chemotherapy Sensitivity in Non-Small Cell Lung Cancer

目的 探究非小细胞肺癌的CT灌注成像参数与表皮生长因子受体(EGFR)表达关系及其在化疗疗效的评价价值。方法 回顾性选取2017年1月—2021年2月期间本院中晚期非小细胞肺癌,并行同步化疗治疗的56例患者。根据患者EGFR基因表达情况分为阳性组与阴性组,根据术后效果分为缓解组与未缓解组,分析比较患者术前、术后的CT灌注成像参数变化,及与EGFR基因的表达和化疗效果的相关性。结果 患者治疗后的血容量(BV)、血流量(BF)、强化峰值(PEI)均显著低于治疗前(P<0.05),而对比剂达峰时间(TTP)明显高于治疗前(P<0.05)。阳性组的BV、BF值均明显高于阴性组患者(P<0.05),而阳性组患者的PEI高于阴性组,TTP低于阴性组,但差异无统计学意义(P>0.05);缓解组中,治疗后的BV、BF、PEI均显著低于治疗前与未缓解组治疗后(P<0.05),而缓解组治疗后的TTP则明显高于治疗前与未缓解组治疗后(P<0.05)。EGFR基因表达阳性与患者的BV、BF水平为正相关(P<0.05),与PEI、TTP无相关性(P>0.05);化疗疗效与治疗后患者的BV、BF水平为正相关(P<0.05),与TTP水平为负相关(P<0.05),与PEI无相关性(P>0.05)。结论 非小细胞肺癌患者EGFR基因突变情况与BV、BF值水平呈正相关,化疗疗效与治疗后患者的BV、BF水平为正相关,与TTP水平为负相关。

Objective To explore the relationship between CT perfusion imaging parameters and epidermal growth factor receptor(EGFR)expression in non-small cell lung cancer and its value in evaluating the efficacy of chemotherapy.Methods 56 patients with advanced non-small cell lung cancer who received concurrent chemotherapy in our hospital from January 2017 to February 2021 were retrospectively selected.Patients were divided into positive group and negative group according to EGFR gene expression,remission group and non-remission group according to postoperative effect,the correlation between preoperative and postoperative CT perfusion imaging parameters of patients and EGFR gene expression and chemotherapy effect was analyzed and compared.Results After treatment,blood volume(BV),blood flow(BF)and enhancement peak(PEI)were significantly lower than before treatment(P<0.05),while peak time of contrast agent(TTP)was significantly higher than before treatment(P<0.05).BV and BF in positive group were significantly higher than those in negative group(P<0.05),while PEI in positive group was higher than that in negative group and TTP was lower than that in negative group,but the differences were not statistically significant(P>0.05).In remission group,BV,BF and PEI after treatment were significantly lower than before and after treatment(P<0.05),while TTP after treatment in remission group was significantly higher than before and after treatment(P<0.05).Positive EGFR gene expression was positively correlated with BV and BF levels(P<0.05),but not with PEI and TTP(P>0.05).The curative effect of chemotherapy was positively correlated with the level of BV and BF after treatment(P<0.05),negatively correlated with the level of TTP(P<0.05),and had no correlation with PEI(P>0.05).Conclusion EGFR gene mutation in NSCLC patients was positively correlated with BV and BF values,and chemotherapy efficacy was positively correlated with BV and BF levels after treatment,but negatively correlated with TTP levels.