Diagnostic observation of 64 slice spiral CT virtual endoscopy combined with CT target scan on bronchial characterization changes of central small cell lung cancer
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摘要:
目的探讨64层螺旋CT（MSCT）仿真内镜联合CT靶扫描在中央型小细胞肺癌（SCLC）诊断中的价值。 方法采用回顾性研究方法，选取2018年1月~2021年2月在我院就诊的中央型SCLC患儿72例作为观察组，同时选取中央型良性病变患者70例作为对照组，分析两组MSCT仿真内镜、CT靶扫描图像。 结果观察组CT靶扫描特征：毛刺征、胸膜凹陷征和空泡征比例分别为33.33%、75.00%和51.39%，高于对照组（P < 0.05）；观察组和对照组CT靶扫描特征中形态不规则、空气支气管征比例差异无统计学意义（P>0.05）；MSCT仿真内镜与纤维支气管镜结果一致性Kappa值为0.782（P < 0.05）；MSCT仿真内镜联合CT靶扫描诊断中央型SCLC的敏感度、准确性和阴性预测值明显高于CT靶扫描（P < 0.05）；MSCT仿真内镜联合CT靶扫描、CT靶扫描诊断中央型SCLC的特异性、阳性预测值比较差异无统计学意义（P>0.05）。 结论MSCT仿真内镜联合CT靶扫描在中央型SCLC诊断中有较好的应用价值，值得临床使用。 Abstract:ObjectiveTo investigate the value of 64 slice spiral CT (MSCT) virtual endoscopy combined with CT target scan in the diagnosis of central small cell lung cancer (SCLC). MethodsA total of 72 children with central SCLC in our hospital from January 2018 to February 2021 were selected as the observation group. Seventy patients with central benign lesions were selected as the control group. The MSCT virtual endoscopy and CT target scanning images were analyzed. ResultsThe age of observation group was significantly higher than that of control group (P < 0.05). The proportions of burr sign, pleural depression sign and vacuolar sign in the CT target scanning features of the observation group were significantly higher than those in the control group (P < 0.05). There was no significant difference between the observation group and the control group in the proportion of irregular morphology and air bronchial sign of the CT target scanning features (P>0.05). The consistent Kappa value of MSCT virtual endoscopy and fiberoptic bronchoscope was 0.782(P < 0.05). The sensitivity, accuracy and negative predictive values of MSCT virtual endoscopy combined with CT target scan in the diagnosis of central SCLC were significantly higher than those of CT target scan (P < 0.05). There was no significant difference in specificity and positive predictive value between MSCT virtual endoscopy combined with CT target scan and CT target scan in the diagnosis of central SCLC (P>0.05). ConclusionMSCT virtual endoscopy combined with CT target scan has a good application value in the diagnosis of central SCLC. -
表 1 观察组和对照组一般资料比较
Table 1. Comparison of general data between observation group and control group
组别 男/女 年龄(岁，Mean±SD) BMI(kg/m2，Mean±SD) 高血压[n(%)] 糖尿病[n(%)] 观察组(n=72) 48/24 62.26±6.69 22.15±2.06 16(22.22) 12(16.67) 对照组(n=70) 50/20 58.84±7.12 22.01±2.73 14(20.00) 10(14.29) t/χ2 0.376 2.951 0.346 0.105 0.154 P 0.54 0.004 0.730 0.746 0.695 
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表 2 观察组和对照组CT靶扫描特征比较
Table 2. Comparison of CT target scanning characteristics between observation group and control group[n(%)]
组别 形态不规则 毛刺征 胸膜凹陷征 空泡征 空气支气管征 观察组(n=72) 26(36.11) 24(33.33) 54(75.00) 37(51.39) 4(5.56) 对照组(n=70) 21(30.00) 6(8.57) 7(10.00) 5(7.14) 2(2.86) χ2 0.599 13.060 61.197 33.359 0.146 P 0.439 0.000 0.000 0.000 0.703
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表 3 MSCT仿真内镜与纤维支气管镜中央型SCLC生长方式判断结果比较
Table 3. Comparison of MSCT virtual endoscopy and fiberoptic bronchoscopy in judging the growth pattern of central SCLC (n)
MSCT仿真内镜 纤维支气管镜 Kappa P 管外型 管壁型 管内型 管外型 18 2 0 0.782 0.000 管壁型 4 22 3 管内型 0 0 14
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表 4 MSCT仿真内镜联合CT靶扫描诊断价值
Table 4. Diagnostic value of MSCT virtual endoscopy combined with CT target scan (%)
方法 敏感度 特异性 准确性 阳性预测值 阴性预测值 CT靶扫描 80.56(58/72) 80.00(56/70) 80.28(114/142) 80.56(58/72) 80.00(56/70) MSCT仿真内镜联合CT靶扫描 93.06(67/72) 91.43(64/70) 92.25(131/142) 91.78(67/73) 92.75(64/69) χ2 4.911 3.733 8.590 3.841 4.790 P 0.027 0.053 0.003 0.050 0.029
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[1] 丁碧娇, 林志敏, 杨毅, 等. 多层螺旋CT平扫联合肿瘤标志物检测对早期肺癌的诊断价值[J]. 解放军医药杂志, 2019, 31(5): 26-9. doi: 10.3969/j.issn.2095-140X.2019.05.006 [2] 王总飞, 杨慧远, 刘先本, 等. 螺旋CT平扫及三期增强扫描在诊断肺癌中的价值研究[J]. 中国CT和MRI杂志, 2019, 17(1): 84-6. doi: 10.3969/j.issn.1672-5131.2019.01.026 [3] 张忠伟, 谢继承, 陈盈, 等. 多层螺旋CT联合能谱CT检查在肺原位腺癌和微浸润腺癌鉴别诊断中的价值研究[J]. 浙江医学, 2019, 41 (1): 40-3, 77. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJYE201901015.htm [4] 李岗, 尤小芳. 64层多层螺旋CT联合Ki-67和神经元特异性烯醇化酶检测与周围型肺癌检出率及病理分型的关系[J]. 中国肿瘤临床与康复, 2020, 27(11): 1290-3. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZK202011005.htm [5] 梁斌, 孙井松, 陈慧红, 等. 多层螺旋CT和直接数字成像系统诊断不同类型肺结核的价值[J]. 分子影像学杂志, 2020, 43(3): 428-33. doi: 10.12122/j.issn.1674-4500.2020.03.12 [6] 赵本好, 申小亮, 马记, 等. 非小细胞肺癌纵隔淋巴结转移的胸部CT表现影像及临床分析[J]. 医学影像学杂志, 2020, 30(1): 147-50. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXZ202001043.htm [7] 张红娟, 武志峰, 鄂林宁, 等. 小细胞肺癌与非小细胞肺癌早晚期CT征象对比分析[J]. 山西医科大学学报, 2019, 50(1): 54-8. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYX201901011.htm [8] 姜颖丹, 王振光. 18F-FDG PET/CT联合增强CT在鉴别中央型小细胞肺癌与鳞状细胞癌中的价值[J]. 新疆医科大学学报, 2019, 42(6): 786-9. doi: 10.3969/j.issn.1009-5551.2019.06.018 [9] Ekman S. HER2: defining a Neu target in non-small-cell lung cancer [J]. Ann Oncol, 2019, 30(3): 353-5. doi: 10.1093/annonc/mdz043 [10] Castagnoli H, Manni C, Marchesani F, et al. The role of 18F-FDG PET/CT in management of paraneoplastic limbic encephalitis combined with small cell lung cancer: a case report[J]. Medicine, 2019, 98(35): e16593. doi: 10.1097/MD.0000000000016593 [11] Zemanova M, Pirker R, Petruzelka L, et al. Care of patients with non- small- cell lung cancer stage Ⅲ - the Central European realworld experience[J]. Radiol Oncol, 2020, 54(2): 209-20. doi: 10.2478/raon-2020-0026 [12] Wrona A, Mornex F. Hypofractionation in early stage non-small cell lung cancer[J]. Semin Radiat Oncol, 2021, 31(2): 97-104. doi: 10.1016/j.semradonc.2020.11.003 [13] 曾艺辉, 吕国义, 喻汉华, 等. 多层螺旋CT在胃癌术前分期中的应用[J]. 中国老年学杂志, 2019, 39(12): 2879-82. doi: 10.3969/j.issn.1005-9202.2019.12.016 [14] Grønberg BH, Killingberg KT, Fløtten Y, et al. High- dose versus standard- dose twice- daily thoracic radiotherapy for patients with limited stage small- cell lung cancer: an open- label, randomised, phase 2 trial[J]. Lancet Oncol, 2021, 22(3): 321-31. doi: 10.1016/S1470-2045(20)30742-7 [15] 何玉鹏, 髙知玲, 贾晶, 等. 多层螺旋CT曲面重组技术在早期胃癌术前病灶显示及临床TN分期中应用价值[J]. 临床放射学杂志, 2020, 39(6): 1203-8. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS202006039.htm [16] Reverberi C, Trovò M. Stereotactic radiotherapy for early- stage non-small cell lung cancer[J]. Mini Invasive Surg, 2020, 4(7): 43. [17] 施豪波, 余一凡, 梁文, 等. 原发性肺淋巴上皮瘤样癌的多层螺旋CT表现及诊断分析[J]. 临床放射学杂志, 2019, 38(4): 634-8. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS201904016.htm [18] Muniz TP, de Jesus VHF, Sousa VAR, et al. A modified recursive partitioning analysis for predicting overall survival in patients with non- small cell lung cancer and central nervous system metastases [J]. J Thorac Dis, 2019, 11(9): 3909-19. [19] 方林, 曹臻. 局灶性机化性肺炎的多层螺旋CT诊断及与周围型肺癌的临床意义分析[J]. 中华肿瘤防治杂志, 2019, 26(S1): 48-9. https://www.cnki.com.cn/Article/CJFDTOTAL-QLZL2019S1033.htm [20] 项国靓, 龙安军, 张依云. 中央型小细胞肺癌与鳞癌患者多层螺旋CT影像特点研究[J]. 实用医学影像杂志, 2019, 20(3): 316-7. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXY201903051.htm -
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