CT灌注成像参数在非小细胞肺癌靶向治疗疗效评估中的应用价值

潘细根 郑悦 邵阳通 陈泓羽 陈福春

[摘要] 目的 探討CT灌注成像参数在非小细胞肺癌靶向治疗疗效评估中的应用价值。 方法 选取2018年6月至2020年6月期间在我院就诊的非小细胞肺癌患者60例，所有患者均予以靶向药物治疗，疗程1个月，根据疗效分为有效组与无效组。两组患者均接受肺CT扫描，并对肿瘤层面行灌注成像。观察患者靶向治疗后疗效，并比较有效组与无效组治疗前和治疗1个月后CT灌注成像参数指标。 结果 治疗1个月后，完全缓解患者14例、部分缓解患者17例、稳定患者15例、进展患者14例。根据疗效分为有效组31例、无效组29例。两组治疗前CT灌注成像参数指标BV及PS水平比较，差异无统计学意义（P>0.05），有效组治疗前CT灌注成像参数指标BF水平[（90.24±10.09）mL/（min·100 g）]高于无效组[（68.46±7.42）mL/（min·100 g）]（P<0.05）。治疗1个月后，无效组BF、BV及PS水平与治疗前比较，差异无统计学意义（P>0.05）;有效组BF、BV及PS水平[（62.75±8.64）mL/（min·100 g）、（3.65±0.59）mL/100 g、（11.26±2.97）mL/（min·100 g）]均较治疗前[（90.24±10.09）mL/（min·100 g）、（5.17±0.78） mL/100 g、（17.45±5.24）mL/（min·100 g）]明显下降（P<0.05）。 结论 CT灌注成像参数能有效地评估非小细胞肺癌靶向治疗的疗效，为临床提供客观的依据。

[关键词] 非小细胞肺癌;靶向治疗;CT灌注成像参数;疗效评估

[中图分类号] R445.2          [文献标识码] B          [文章编号] 1673-9701（2021）28-0118-04

Application value of CT perfusion imaging parameters in efficacy evaluation of targeted therapy for non-small cell lung cancer

PAN  Xigen1   ZHENG Yue1   SHAO Yangtong1   CHEN Hongyu1   CHEN Fuchun2

1.Department of Radiology， Wenling Hospital of Traditional Chinese Medicine in Zhejiang Province， Wenling 317500，China; 2.Department of Thoracic Surgery， Wenling Hospital of Traditional Chinese Medicine in Zhejiang Province， Wenling    317500， China

[Abstract] Objective To explore the application value of CT perfusion imaging parameters in efficacy evaluation of targeted therapy for non-small cell lung cancer. Methods A total of 60 patients with NSCLC admitted to our hospital from June 2018 to June 2020 were selected. All patients were treated with targeted drug therapy for one month， and were divided into the effective group and the ineffective group according to the efficacy. Both groups were given lung CT scan and perfusion imaging at the tumor level. The efficacy of patients after targeted therapy was observed， and the parameters of CT perfusion imaging before treatment and one month after treatment were compared between the effective group and the ineffective group. Results After 1 month of treatment，there were 14 patients with complete response， 17 with partial response，15 with stable response， and 14 with progress. According to the curative effect，they were divided into the effective group （31 patients） and the ineffective group （29 patients）. Before treatment， there was no significant differences in the BV and PS levels between the two groups （P>0.05）， and the level of BF in the effective group [（90.24±10.09） mL/（min·100 g）] was higher than that in the ineffective group [（68.46±7.42） mL/（min·100 g）]（P<0.05）. After one month of treatment，the levels of BF， BV and PS in the ineffective group were not significantly different from those before treatment（P>0.05）. The levels of BF， BV and PS in effective group after treatment[（62.75±8.64） mL/（min·100 g），（3.65±0.59） mL/100 g， （11.26±2.97） mL/（min·100 g）]were significantly lower than those before treatment [（90.24±10.09） mL/（min·100 g）， （5.17±0.78） mL/100 g， （17.45±5.24） mL/（min·100 g）]（P<0.05）. Conclusion CT perfusion imaging parameters can effectively evaluate the efficacy of targeted therapy for non-small cell lung cancer， and provide an objective basis for clinical practice.

[Key words] Non-small-cell lung cancer; Targeted therapy; CT perfusion imaging parameters; Therapeutic effect evaluation

非小细胞肺癌是临床常见的恶性肿瘤之一，其发病率高、病死率高[1-2]。非小细胞肺癌常采用手术及放化疗等治疗，但传统的治疗方法敏感性较差，疗效有限，患者的生存期和预后均未能达到患者的预期要求[3-4]。近年来，随着对肺癌研究的增多，靶向治疗成为治疗非小细胞癌的重要方法之一，其治疗效果受到关注，但目前临床上缺乏有效的疗效评估手段[5]。CT灌注成像是新型的辅助检查手段，它不同于动态扫描，是在静脉快速团注对比剂时，对感兴趣区层面进行连续CT扫描，从而获得感兴趣区时间--密度曲线，并利用不同的数学模型，计算出各种灌注参数值。近年……