中国中西医结合影像学杂志2024，Vol.22Issue(1)：72-79,8.DOI:10.3969/j.issn.1672-0512.2024.01.015
术前CT在诊断非小细胞肺癌脏层胸膜浸润中的应用价值
Value of preoperative CT in diagnosis of non-small cell lung cancer with visceral pleural invasion
摘要
Abstract
Objective:To investigate the value of preoperative CT in diagnosis of non-small cell lung cancer(NSCLC)with visceral pleural invasion(VPI).Methods:A total of 489 NSCLC patients were retrospectively included and divided into the training set(362 cases)and the validation set(127 cases).Each set was divided into VPI group and non-VPI group according to the results of elastic fiber staining.In the training set,there were 57 cases in VPI group and 305 cases in non-VPI group.And in the validation set,there were 15 cases in VPI group and 112 cases in non-VPI group.The pathological features,clinical data and CT characteristics of VPI group and non-VPI group were summarized.Through univariate analysis and binary logistic regression,the independent risk factors were screened and combined models were established.The ROC curve was used to compare the diagnostic efficiency of each model.Results:In the training set,there were statistical differences between VPI group and non-VPI group in nodular type,air bronchial sign,type of pleural contact,length of solid contact,long diameter,short diameter,CTmin value and CTmean value(all P<0.05).After multivariate logistic regression was used to eliminate the confounding factors,the length of solid contact and type of pleural contact were independent risk factors for predicting VPI(both P<0.01).The best cut-off value of solid contact length was 8.5 mm,with a sensitivity of 80.7%and a specificity of 55.4%.In the training set,the AUCs of models among the combined model 1 based on the statistically significant factors in the univariate analysis,the combined model 2 established by two independent risk factors and the model established by solid contact length were 0.775,0.755 and 0.734,respectively,and in the validation set,the AUCs of the three models were 0.789,0.740 and 0.682,respectively.There were no significant differences among the three models either in the training set or in the validation set(all P>0.05).Conclusion:The length of solid contact and the type of pleural contact can be used as independent risk factors for distinguishing VPI,which can provide non-invasive guidance for clinical preoperative decision-making.关键词
肺肿瘤/脏层胸膜浸润/癌,非小细胞肺/体层摄影术,X线计算机Key words
Lung neoplasms/Visceral pleural invasion/Carcinoma,non-small cell lung/Tomography,X-ray computed引用本文复制引用
杨扬,王健,杨光钊,茅国群,徐文杰,刘珺,杨昭,李伟,谢宗玉..术前CT在诊断非小细胞肺癌脏层胸膜浸润中的应用价值[J].中国中西医结合影像学杂志,2024,22(1):72-79,8.基金项目
浙江省卫健委项目(2021KY602,2022KY702) （2021KY602,2022KY702）
安徽省重点研究与开发计划(2022e07020033) （2022e07020033）
安徽省中央引导地方科技发展资金项目(2020b07030008). （2020b07030008）
