CAJ | 학술논문

目的探讨螺旋CT三维定量测量评估I期非小细胞肺癌（NSCLC）肿瘤最大径及术前T分期的价值。资料与方法125例经手术病理证实的I期NSCLC患者，均有完整的CT检查资料，评估CT三维定量测量与二维测量、大体病理测量肿瘤最大径及T分期的差异。结果 CT三维定量测量、二维测量及大体病理测量125例患者的肿瘤平均最大径分别为（26.21±8.14）mm、（27.03±9.90）mm、（25.60±9.31）mm；二维测量与三维定量测量、大体病理测量肿瘤最大径差异均有统计学意义（t=2.377, P<0.05；t=2.961, P<0.01），三维定量测量与大体病理测量肿瘤最大径差异无统计学意义（t=1.281, P>0.05）；Bland-Altman分析显示，以大体病理测量结果作为“金标准”，三维定量测量较二维测量一致性更高；在此基础上，以三维定量测量结果为对照，有25例（20%）二维测量分期结果与其不一致。结论螺旋CT三维定量测量对I期NSCLC肿瘤最大径测量及术前分期结果较二维测量更准确，可以为NSCLC患者术前分期、评估预后和疗效提供更准确的评价标准。
목적탐토라선CT삼유정량측량평고I기비소세포폐암（NSCLC）종류최대경급술전T분기적개치。자료여방법125례경수술병리증실적I기NSCLC환자，균유완정적CT검사자료，평고CT삼유정량측량여이유측량、대체병리측량종류최대경급T분기적차이。결과 CT삼유정량측량、이유측량급대체병리측량125례환자적종류평균최대경분별위（26.21±8.14）mm、（27.03±9.90）mm、（25.60±9.31）mm；이유측량여삼유정량측량、대체병리측량종류최대경차이균유통계학의의（t=2.377, P<0.05；t=2.961, P<0.01），삼유정량측량여대체병리측량종류최대경차이무통계학의의（t=1.281, P>0.05）；Bland-Altman분석현시，이대체병리측량결과작위“금표준”，삼유정량측량교이유측량일치성경고；재차기출상，이삼유정량측량결과위대조，유25례（20%）이유측량분기결과여기불일치。결론라선CT삼유정량측량대I기NSCLC종류최대경측량급술전분기결과교이유측량경준학，가이위NSCLC환자술전분기、평고예후화료효제공경준학적평개표준。
Purpose To investigate the value of three-dimensional quantitative measurement of spiral CT in evaluating tumor size and preoperative T stage in stage I non-small cell lung cancer (NSCLC). Materials and Methods The complete data of 125 patients with stage I NSCLC confirmed surgically and pathologically were compared in terms of maximum tumor diameter and T stage analysis by means of three-dimensional quantitative CT measurement, two-dimensional measurement and general pathology measurement. Results The mean maximum tumor diameter of these 125 patients measured by quantitative three-dimensional CT measurement, two-dimensional measurement and general pathology measurement were (26.21±8.14) mm, (27.03±9.90) mm and (25.60±9.31) mm, respectively. The difference in mean maximum tumor diameter by two-dimensional measurement and three-dimensional quantitative measurement was significant, and remained so when two-dimensional measurement and pathology measurement was compared (t=2.377, P<0.05;t=2.961, P<0.01), but that between three-dimensional quantitative measurement and pathology measurement was not significant (t=1.281, P>0.05). Bland-Altman analysis showed that three-dimensional quantitative measurement had higher consistency than two-dimensional measurement when compared with the gold standard pathology measurement. When three-dimensional quantitative measurement was taken to be the staging criterion, 20% results (25 cases) obtained by two-dimensional measurement proved to be inconsistent. Conclusion Compared with two-dimensional measurement, quantitative three-dimensional CT measurement can provide more accurate information in maximum tumor diameter and T stage for patients with stage I NSCLC, therefore can be applied as a more accurate criterion in preoperative staging and prognosis of stage I NSCLC.