非小细胞肺癌缺氧状态下酸化与CT纹理相关性分析

Correlation between hypoxia-induced acidification and CT texture in non-small cell lung cancer

目的:通过分析CT纹理特征改变,依据肿瘤缺氧生长分子基因机制,明确酸化与CT纹理关系,提高酸化肿瘤穿刺精确性。方法:选择62例非小细胞肺癌(non-small cell lung cancer,NSCLC)患者,其中基因野生型31例,突变型31例,从CT增强图像中选取感兴趣区(region of interest,ROI)测量同一病例病灶整体CT值,3个低密度区CT均值,使用公式计算相对CT值,判断乳酸化、磷酸化CT值区间范围。利用CT肺肿块高级多功能软件,重建出肿块三维立体内部解剖结构图像,明确CT形态学表现与肿瘤缺氧状态下酸化的关系。结果:野生型整体区域CT值为(57.8±25.1)HU,ROI区域CT值为(27.3±5.4)HU;突变型整体区域CT值为(49.4±24.6)HU,ROI区域CT值为(17.5±5.4)HU。野生型组相对CT值<0.25,突变型组相对CT值0.25~0.5。野生型组出现湿地征比例为81%,突变型组出现沼泽征比例为84%。结论:CT纹理特征对NSCLC缺氧状态下酸化有明显的提示效应,可以提高酸化肿瘤穿刺精确性,对基因突变具有一定预测价值。

Objective:To explore the relationship between acidification and CT texture by analyzing the change of CT textural features based on the molecular mechanism of tumor hypoxia,so to improve the accuracy of needle biopsy of tumor.Methods:A total of 62 patients with non-small cell lung cancer(NSCLC)were selected and analyzed,including 31 cases of wild type(WT)gene and 31 cases of mutant type gene.The CT value of the lesion of the same case was measured from the region of interest(ROI)in CT enhancement image.The average CT value of the three low-density areas was measured,and the relative CT value was calculated with the formula.The range of CT values in lactylation and phosphorylation was determined.The 3D anatomical structure image of the mass was reconstructed using the advanced multi-functional software for CT lung mass,and the relationship between CT morphological features and hypoxia-induced acidification was evaluated.Results:CT value of the wild-type gene region was(57.8±25.1)HU,with the CT value of(27.3±5.4)HU in the ROI region.The CT value mutant gene region was(49.4±24.6)HU,with the CT value of(17.5±5.4)HU in the ROI region.The relative CT value in the wild-type gene group was<0.25,and the mutant gene group had a relative CT value of 0.25 to 0.5.The proportion of wetland signs occurred in the wild-type gene group was 81%and 84%in the mutant gene group.Conclusion:The CT textural features could effectively suggest acidification of NSCLC under hypoxic state,which could improve the accuracy of needle biopsy of tumor and predict gene mutation.