| 段晓蓓,陈相猛,黄斌豪,邹伟强,秦贵磷,孙丽霞.18F-FDG PET/CT及高分辨率CT预测TNM Ⅰ期肺腺癌脏层胸膜侵犯[J].中国医学影像技术,2021,37(10):1486~1491 |
| 18F-FDG PET/CT及高分辨率CT预测TNM Ⅰ期肺腺癌脏层胸膜侵犯 |
| 18F-FDG PET/CT and high resolution CT for predicting pleural invasion in TNM stage Ⅰ lung adenocarcinoma with pleural contact |
| 投稿时间：2020-03-14 修订日期：2021-09-01 |
| DOI：10.13929/j.issn.1003-3289.2021.10.013 |
| 中文关键词: 肺肿瘤 腺癌 正电子发射断层显像 体层摄影术,X线计算机 |
| 英文关键词:lung neoplasms adenocarcinoma positron-emission tomography tomography, X-ray computed |
| 基金项目:广东省医学科研基金（A2021138）。 |
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| 中文摘要: |
| 目的 观察18F-FDG PET/CT及高分辨率CT（HRCT）预测TNM Ⅰ期肺腺癌脏层胸膜侵犯（VPI）的价值。方法 回顾性分析72例术前接受18F-FDG PET/CT检查、HRCT示原发灶与胸膜存在接触的TNM Ⅰ期肺腺癌患者，依据病理所见VPI分为阳性组（n=21）和阴性组（n=51），将其原发灶与胸膜的接触关系分为Ⅰ~Ⅳ型。以单因素分析比较2组性别、年龄、病灶位置、最大标准摄取值（SUVmax）、胸膜接触类型及HRCT表现的差异；采用多因素Logistic回归分析筛选预测VPI阳性的独立危险因素并建立回归模型，以受试者工作特征（ROC）曲线确定最佳临界值。结果 组间胸膜接触类型和SUVmax差异均有统计学意义（P均<0.05）；胸膜接触类型[OR=2.047，95%CI（1.061，3.951），P=0.033]和SUVmax[OR=1.234，95%CI（1.076，1.415），P=0.003]为预测VPI的独立危险因素。分别以9.0及Ⅳ型为SUVmax及胸膜接触的最佳阈值，其曲线下面积（AUC）分别为0.798和0.715，敏感度分别为76.2%和57.1%，特异度分别为72.5%和78.4%；二者联合模型的AUC为0.807，敏感度和特异度分别为66.7%和80.4%。结论 18F-FDG PET/CT及HRCT有助于预测TNM Ⅰ期肺腺癌VPI；SUVmax及胸膜接触Ⅳ型为VPI独立危险因素。 |
| 英文摘要: |
| Objective To explore the value of 18F-FDG PET/CT and high-resolution CT (HRCT) for predicting visceral pleural invasion (VPI) of TNM stage Ⅰ lung adenocarcinoma. Methods Totally 72 patients with TNM stage I lung adenocarcinoma confirmed by surgery and pathology in contact with pleura on HRCT who underwent 18F-FDG PET/CT before operation were retrospectively analyzed. The patients were divided into VPI positive group (n=21) and negative group (n=51), and the contact relationships of pulmonary lesions and pleura were divided into type Ⅰ-Ⅳ. Univariate analysis was used to compare patients' gender, age, lesion location, the maximum standard uptake value (SUVmax), pleural contact type and HRCT findings between groups. Multivariate Logistic regression analysis was performed to screen the independent risk factors for predicting positive VPI, and a regression model was established, and the best critical value was assessed with receiver operating characteristic (ROC) curve. Results There were significant differences of pleural contact type and SUVmax between groups (both P<0.05). Pleural contact type (OR=2.047, 95%CI [1.061, 3.951], P=0.033) and SUVmax (OR=1.234, 95%CI [1.076, 1.415], P=0.003) were independent risk factors for predicting VPI. Taken 9.0 and type Ⅳ as the best threshold of SUVmax and pleural contact, respectively, the area under the curve (AUC) was 0.798 and 0.715, the sensitivity was 76.2% and 57.1%, and the specificity was 72.5% and 78.4%, respectively. The AUC of the combined model was 0.807, with sensitivity of 66.7% and specificity of 80.4%. Conclusion 18F-FDG PET/CT and HRCT were helpful to predicting VPI of TNM stageⅠ lung adenocarcinoma. SUVmax and pleural contact type Ⅳ were independent risk factors of positive VPI. |
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