临床医学工程2025，Vol.32Issue(3)：327-332,6.DOI:10.3969/j.issn.1674-4659.2025.03.0327
增强CT结合血清肿瘤标志物对NSCLC患者近期预后不良的预测价值分析
Analysis on the Predictive Value of Enhanced CT Combined with Serum Tu-mor Markers for Poor Short-Term Prognosis of Patients with NSCLC
摘要
Abstract
Objective To analyze the predictive value of enhanced CT combined with serum tumor markers for poor short-term prognosis of patients with non-small cell lung cancer(NSCLC).Methods 140 patients with NSCLC admitted to our hospital from May 2019 to May 2022 were selected,and all of them underwent enhanced CT scanning and serum tumor marker detection before treatment.Patients'prognosis was counted in 1 year of follow-up,and patients were divided into the poor prognosis group and the good prognosis group.The general data,enhanced CT parameters and serum tumor marker levels of the two groups were compared;COX risk proportional regression model was used to analyze the influencing factors of poor short-term prognosis of patients with NSCLC.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficiency of enhanced CT parameters combined with serum tumor markers for poor short-term prognosis of patients with NSCLC.Results 140 patients with NSCLC were followed up for 1 year,and 9 patients were lost to follow-up;The incidence of poor prognosis in the remaining 131 patients was 30.53%(40/131).The performance status(PS)score and the proportions of smoking,coronary heart disease,TNM stage Ⅲ～Ⅳ,tissue differentiation degree of non/low differentiation in the poor prognosis group were higher than those in the good prognosis group(P<0.05),while the proportion of surgical resection+radiotherapy and chemotherapy+immunotherapy was lower than that in the good prognosis group(P<0.05).The maximum long diameter of tumor,the difference of CT value before and after enhancement,and the levels of serum CYFRA21-1,CEA and NSE in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The analysis result of COX risk proportional regression model showed that smoking,coronary heart disease,TNM stage,differentiation degree,maximum long diameter of tumor,the difference of CT value before and after enhancement,CYFRA21-1 and NSE were the influencing factors of poor short-term prognosis in NSCLC patients(P<0.05).ROC curve showed that the AUC of maximum long diameter of tumor,difference of CT value before and after enhancement,CYFRA21-1 and NSE in predicting poor prognosis of patients with NSCLC were 0.797,0.811,0.730 and 0.792,respectively;The AUC of the combination of the four was 0.907;Pairwise algorithm test showed that the AUC of the combined prediction of the four showed an increase compared with the single prediction of maximum long diameter of tumor,the difference of CT value before and after enhancement,CYFRA21-1 and NSE.Conclusions The maximum long diameter of tumor,the difference of CT value before and after enhancement,and the serum tumor markers(CYFRA21-1 and NSE)are the influencing factors of poor short-term prognosis in NSCLC patients.The combination of the four has high predictive efficiency for the poor short-term prognosis of NSCLC patients.关键词
非小细胞肺癌/增强CT/肿瘤标志物Key words
Non-small cell lung cancer/Enhanced computed tomography/Tumor marker分类
临床医学引用本文复制引用
孟轲,王亚洲..增强CT结合血清肿瘤标志物对NSCLC患者近期预后不良的预测价值分析[J].临床医学工程,2025,32(3):327-332,6.基金项目
河南省中医药科学研究专项课题(2024ZY3017) （2024ZY3017）
