能谱CT定量分析技术在肺腺癌一线化疗后疗效评估中的临床价值

CLINICAL VALUE OF SPECTRUM CT QUANTITATIVE ANALYSIS TECHNIQUE IN EVALUATING EFFICACY OF FIRST-LINE CHEMOTHERAPY FOR LUNG ADENOCARCINOMA

目的 能谱CT定量分析技术在肺腺癌一线化疗后临床疗效评估中的应用价值。方法 采用双盲法随机抽取2019年9月—2021年9月该院收治的96例肺腺癌患者作为本次观察对象。所有患者均在化疗前、第一次化疗后、第二次化疗后分别进行能谱CT增强检查,在第二次化疗后观察肿瘤大小,并按照RECIST1.1标准将化疗后96例患者中缓解、稳定45例归为有效组,病情进展51例归为无效组。以此45例治疗有效患者为研究对象,分析其化疗一周期前后常规CT参数及能谱CT参数变化情况。结果 45例首次化疗前后静脉期常规扫描CT值对比无差异,且患者肿瘤长径参数无统计学差异(P>0.05);首次化疗后40Kev水平下单能量CT值、能谱曲线斜率k及标准化碘浓度(NIC)均低于化疗前,差异有统计学意义(P<0.05),三种指标的灵敏度分别为62.2%、68.9%、73.3%,特异度分别为64.4%、64.4%、71.1%。结论 能谱CT定量技术评价贝伐珠单抗化疗效果,优于常规CT扫描,可作为后续治疗方案调整的依据。

Objective To explore the application value of spectral CT quantitative analysis technology in the clinical efficacy evaluation of lung adenocarcinoma after first-line chemotherapy. Methods 96 patients with lung adenocarcinoma admitted to our hospital from September 2019 to September 2021 were randomly selected by double blind method as the subjects of this study.All patients were examined with spectral CT enhancement before chemotherapy and after the first and second chemotherapy, and the tumor size was observed with CT after the second chemotherapy.According to RECIST 1.1 standard, 45 patients with remission and stability after chemotherapy were classified as the effective group, and 51 patients with disease progression were classified as the ineffective group.Taking 45 patients with effective treatment as the research object, we analysed the changes of conventional CT parameters and spectrum CT parameters before and after one cycle of chemotherapy. Results There was no significant difference in the routine CT scanning values of 45 patients before and after the first chemotherapy, and there was no significant difference in tumor diameter parameters(P<0.05);The single energy CT value at the 40Kev level, slope k and normalized iodine concentration(NIC) after the first chemotherapy were lower than those before the first chemotherapy, and the difference was statistically significant(P<0.05).The sensitivity of the three indicators were 62.2%、68.9%、73.3% respectively, the specificity was 64.4%、64.4%、71.1% respectively. Conclusion The spectral CT quantitative technique is superior to the conventional CT scanning in evaluating the chemotherapy effect of Befazumab, which can be used as the basis for the adjustment of the follow-up treatment plan.