摘要
目的分析^(18)F-FDG PET/CT影像学特征在T1~2期肺腺癌气腔内播散(STAS)中的预测价值。方法回顾性分析2018年6月至2020年6月间在江门市中心医院行^(18)F-FDG PET/CT检查并经手术病理证实的T1~2期肺腺癌患者80例[男36例,女44例;年龄:19~84(59.9±11.8)岁]。依据病理结果分为STAS阳性组和阴性组。采用两独立样本t检验、Mann-Whitney U检验、χ^(2)检验或Fisher确切概率法分析2组患者的性别、年龄、肿瘤标志物、SUV_(max)、SUV_(mean)、高分辨率CT(HRCT)影像学征象(径线、位置、形态、密度、分叶征、毛刺征、空泡征、空气支气管征、胸膜牵拉征和周围肺气肿)、病理学特征(微乳头状结构、脉管侵犯、胸膜侵犯、淋巴结转移)的差异,再进行多因素logistic回归分析;采用ROC曲线评估各参数诊断T1~2期肺腺癌患者STAS的效能。结果80例T1~2期肺腺癌患者中,12例(15.0%)STAS阳性,68例(85.0%)STAS阴性。SUV_(max)、SUV_(mean)、微乳头状结构、脉管侵犯、淋巴结转移在2组患者间的差异具有统计学意义(z值:-2.60、-2.17;χ^(2)值:29.56、9.28、17.40,P<0.001或P<0.05)。多因素logistic回归分析提示SUV_(max)[比值比(OR)=1.348(95%CI:1.071~1.695),P=0.011]、微乳头状结构[OR=47.444(95%CI:4.592~490.214),P=0.001]、淋巴结转移[OR=8.201(95%CI:1.129~59.576),P=0.038]为肺腺癌STAS的独立危险预测因素。ROC曲线分析示SUV_(max)最佳界值为3.85时,AUC为0.737(95%CI:0.614~0.859),灵敏度为11/12,特异性为55.9%(38/68),准确性为61.2%(49/80);SUV_(max)联合微乳头状结构、淋巴结转移的AUC为0.945(95%CI:0.892~0.999),灵敏度为11/12,特异性为88.2%(60/68),准确性为88.7%(71/80)。结论^(18)F-FDG PET/CT影像学特征与肺腺癌STAS状态有关,肺腺癌的SUV_(max)>3.85、病理为微乳头状结构且伴有淋巴结转移,预测肺腺癌STAS发生的准确性高。
Objective To evaluate the clinical value of^(18)F-FDG PET/CT findings in patients with T1-2 lung adenocarcinoma spread through air spaces(STAS).Methods From June 2018 to June 2020,a total of 80 patients(36 males,44 females;age:19-84(59.9±11.8)years)with surgically and pathologically confirmed T1-2 lung adenocarcinomas in Jiangmen Central Hospital were enrolled retrospectively.All patients underwent^(18)F-FDG PET/CT examination preoperatively and were divided into STAS positive and negative groups according to the histopathological diagnosis.Independent-sample t test,Mann-Whitney U test,χ^(2)test and Fisher exact test were used to analyze differences of gender,age,tumor biomarker,SUV_(max),SUV_(mean),features showed on high resolution CT(HRCT;including diameter,lesion location,morphology,density,lobulated sharp,spiculated sign,vacuole sign,air bronchgram sign,pleural traction and para-emphysema),and pathologic findings(micropapillary pattern,lymphvascular inversion,pleural inversion and lymph node metastasis)between the two groups,and then multivariate logistic regression was performed.The ROC curve was employed to evaluate the predictive value of parameters for STAS of T1-2 lung adenocarcinomas.Results Among the 80 patients with T1-2 lung adenocarcinomas,12(15.0%)were STAS positive and 68(85.0%)were STAS negative.Significant differences were shown in SUV_(max),SUV_(mean),micropapillary pattern,lymphvascular inversion and lymph node metastasis between the two groups(z values:-2.60,-2.17;χ^(2)values:29.56,9.28,17.40,P<0.001 or P<0.05).SUV_(max)(odds ratio(OR):1.348(95%CI:1.071-1.695),P=0.011),micropapillary pattern(OR=47.444(95%CI:4.592-490.214),P=0.001)and lymph node metastasis(OR=8.201(95%CI:1.129-59.576),P=0.038)were independent risk factors for STAS positive in multivariation logistic regression analysis.The optimum cut-off value for SUV_(max)was 3.85 in the ROC analysis with the AUC of 0.737(95%CI:0.614-0.859),the sensitivity of 11/12,the specificity of 55.9%(38/68)and the accuracy of 61.2%(49/80).The AUC o
作者
段晓蓓
陈相猛
黄斌豪
孙丽霞
邹伟强
伍日照
秦贵磷
Duan Xiaobei;Chen Xiangmeng;Huang Binhao;Sun Lixia;Zou Weiqiang;Wu Rizhao;Qin Guilin(Department of Nuclear Medicine,Jiangmen Central Hospital,the Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen 529030,China;Department of Radiology,Jiangmen Central Hospital,the Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen 529030,China;Department of Pathology,Jiangmen Central Hospital,the Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen 529030,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第5期263-268,共6页
Chinese Journal of Nuclear Medicine and Molecular Imaging
