高分辨率计算机断层扫描定量参数联合血管分型评估肺腺癌侵袭性的应用价值

The Application Value of HRCT Quantitative Parameters Combined with Vascular Classification in Evaluating the Invasiveness of Lung Adenocarcinoma

目的 探讨高分辨率计算机断层扫描(HRCT)定量参数联合血管分型评估肺腺癌侵袭性的应用价值。方法 选取本院2021年3月至2023年6月经手术病理证实的肺腺癌患者113例(共138枚肺结节),根据病理类型将其分为非侵袭性组81枚(不典型腺瘤样增生、原位腺癌、微浸润性腺癌)和侵袭性组57枚(浸润性腺癌)。比较两组的临床资料、HRCT定量参数和结节血管分型,构建Logistic回归模型,并通过受试者工作特征(ROC)曲线评估HRCT定量参数联合血管分型预测侵袭性肺腺癌的价值。结果 侵袭性组的结节最大直径、磨玻璃成分平均CT值、CT差值、体积、质量、血管分型为Ⅲ/Ⅳ型的比例均大于非侵袭性组(P<0.05)。多因素Logistic回归分析显示,结节最大直径、磨玻璃成分平均CT值、CT差值、体积、质量、血管分型是侵袭性肺腺癌的独立危险因素(P<0.05)。ROC曲线分析结果显示,结节最大直径、磨玻璃成分平均CT值、CT差值、体积、质量、血管分型以及联合检测评估侵袭性肺腺癌的曲线下面积分别为0.619、0.669、0.753、0.747、0.728、0.799、0.861,HRCT定量参数联合血管分型评估侵袭性肺腺瘤的价值高于单一指标。结论 HRCT定量参数与血管分型联合检测对侵袭性肺腺癌具有较好的预测效能,对肺腺癌患者具有临床应用价值。

Objective To explore the application value of high-resolution computed tomography(HRCT)quantitative parameters combined with vascular classification in evaluating the invasiveness of lung adenocarcinoma.Methods 113 patients with lung adenocarcinoma(a total of 138 nodules)confirmed by surgical pathology from March 2021 to June 2023 in our hospital were selected and divided into a non-invasive group of 81 patients(atypical adenoma hyperplasia/adenocarcinoma in situ/microinvasive adenocarcinoma)and 57 in the invasive group(invasive adenocarcinoma)according to the pathological type.The clinical data,HRCT quantitative parameters and nodule vascular classification of the two groups were compared,a Logistic regression model was constructed,and the receiver operating characteristic(ROC)curve was used to evaluate the value of HRCT quantitative parameters combined with vascular classification in predicting invasive lung adenocarcinoma.Results The maximum diameter of nodules,average CT value of ground glass component,CT difference value,volume,mass,and the proportion of blood vessel classification of type III/IV in the invasive group were all greater than those in the non-invasive group(P<0.05).Multivariate Logistic regression analysis showed that the maximum diameter of the nodule,average CT value of ground glass component,CT difference value,volume,mass,and blood vessel type were independent risk factors for invasive lung adenocarcinoma(P<0.05).The results of the ROC curve analysis showed that the maximum diameter of the nodule,the average CT value of the ground glass component,the CT difference value,the volume,the mass,the blood vessel classification,and the areas under the curve of combined detection to evaluate invasive lung adenocarcinoma were 0.619,0.669,0.753,0.747,0.728,0.799,0.861,respectively.The evaluation value of HRCT quantitative parameters combined with vascular classification was higher than that of a single indicator.Conclusion The combined detection of HRCT quantitative parameters and vascular classification has good predictive performance for invasive lung adenocarcinoma and has clinical application value in patients with lung adenocarcinoma.