CAJ | 학술논문

目的：：探讨CT灌注参数和VEGF( vascular endothelial growth factor, VEGF )表达对非小细胞肺癌放疗后近期疗效评价和预测价值。方法：收集2010年4月~2013年11月我院病理证实非小细胞肺癌患者58例。所有患者在放射治疗前和放射治疗结束4周后分别行肺部肿瘤CT灌注扫描,并对患者病理切片行VEGF染色。比较非小细胞肺癌在放疗前和放疗后各灌注参数：血流量BF( blood flow, BF)、血容量BV( blood volume, BV)、平均通过时间MTT( mean transit time, MTT)、表面通透性PS( permeability surface, PS)、肿块动脉强化峰值PH ( peak height, PH)的变化,同时比较VEGF阳性表达组和VEGF阴性表达组各灌注参数变化值差异,以及放疗后肿瘤有效(完全或部分缓解)组与无效(稳定或进展)组各灌注参数变化值及VEGF表达差异,通过ROC法评价放疗前各灌注参数对非小细胞肺癌放疗后近期疗效的预测诊断价值,并对VEGF表达情况对非小细胞肺癌接受放疗后近期疗效影响进行分析。结果：放疗后病灶评价为有效(完全或部分缓解)49例,评价为无效(稳定或进展)9例。非小细胞肺癌放疗后BF(t=6．282,P=0．000)、BV(t=5．230,P=0．000)、PH(t=3．954,P=0．009)值均较放疗前明显降低。 VEGF阳性表达组患者肿瘤放疗前后BF(t=5．222,P=0．000)、BV(t=4．121,P=0．006)、PH(t=3．654,P=0．013)降低值较VEGF阴性表达组明显。同时放疗后评价为有效组肿瘤灌注参数BF(t=6．122,P=0．000)、BV (t=5．221,P=0．000)、PH(t=2．854,P=0．032)降低值均较无效组明显。 VEGF阳性表达组非小细胞肺癌放疗后缓解率较VEGF阴性表达组高(χ2=8．145,P=0．004)。 ROC 分析结果表明肿瘤血流量 BF(AUC =0．827,P =0．000)、血容量BV(AUC=0．887,P=0．000)不仅AUC>0．5,且与AUC为0．5的曲线差异有统计学意义。结论：非小细胞肺癌放疗前肿瘤灌注参数中的BF、BV与VEGF对评价和预测非小细胞肺癌放疗后近期疗效有价值。目的：：探討CT灌註參數和VEGF( vascular endothelial growth factor, VEGF )錶達對非小細胞肺癌放療後近期療效評價和預測價值。方法：收集2010年4月~2013年11月我院病理證實非小細胞肺癌患者58例。所有患者在放射治療前和放射治療結束4週後分彆行肺部腫瘤CT灌註掃描,併對患者病理切片行VEGF染色。比較非小細胞肺癌在放療前和放療後各灌註參數：血流量BF( blood flow, BF)、血容量BV( blood volume, BV)、平均通過時間MTT( mean transit time, MTT)、錶麵通透性PS( permeability surface, PS)、腫塊動脈彊化峰值PH ( peak height, PH)的變化,同時比較VEGF暘性錶達組和VEGF陰性錶達組各灌註參數變化值差異,以及放療後腫瘤有效(完全或部分緩解)組與無效(穩定或進展)組各灌註參數變化值及VEGF錶達差異,通過ROC法評價放療前各灌註參數對非小細胞肺癌放療後近期療效的預測診斷價值,併對VEGF錶達情況對非小細胞肺癌接受放療後近期療效影響進行分析。結果：放療後病竈評價為有效(完全或部分緩解)49例,評價為無效(穩定或進展)9例。非小細胞肺癌放療後BF(t=6．282,P=0．000)、BV(t=5．230,P=0．000)、PH(t=3．954,P=0．009)值均較放療前明顯降低。 VEGF暘性錶達組患者腫瘤放療前後BF(t=5．222,P=0．000)、BV(t=4．121,P=0．006)、PH(t=3．654,P=0．013)降低值較VEGF陰性錶達組明顯。同時放療後評價為有效組腫瘤灌註參數BF(t=6．122,P=0．000)、BV (t=5．221,P=0．000)、PH(t=2．854,P=0．032)降低值均較無效組明顯。 VEGF暘性錶達組非小細胞肺癌放療後緩解率較VEGF陰性錶達組高(χ2=8．145,P=0．004)。 ROC 分析結果錶明腫瘤血流量 BF(AUC =0．827,P =0．000)、血容量BV(AUC=0．887,P=0．000)不僅AUC>0．5,且與AUC為0．5的麯線差異有統計學意義。結論：非小細胞肺癌放療前腫瘤灌註參數中的BF、BV與VEGF對評價和預測非小細胞肺癌放療後近期療效有價值。
목적：：탐토CT관주삼수화VEGF( vascular endothelial growth factor, VEGF )표체대비소세포폐암방료후근기료효평개화예측개치。방법：수집2010년4월~2013년11월아원병리증실비소세포폐암환자58례。소유환자재방사치료전화방사치료결속4주후분별행폐부종류CT관주소묘,병대환자병리절편행VEGF염색。비교비소세포폐암재방료전화방료후각관주삼수：혈류량BF( blood flow, BF)、혈용량BV( blood volume, BV)、평균통과시간MTT( mean transit time, MTT)、표면통투성PS( permeability surface, PS)、종괴동맥강화봉치PH ( peak height, PH)적변화,동시비교VEGF양성표체조화VEGF음성표체조각관주삼수변화치차이,이급방료후종류유효(완전혹부분완해)조여무효(은정혹진전)조각관주삼수변화치급VEGF표체차이,통과ROC법평개방료전각관주삼수대비소세포폐암방료후근기료효적예측진단개치,병대VEGF표체정황대비소세포폐암접수방료후근기료효영향진행분석。결과：방료후병조평개위유효(완전혹부분완해)49례,평개위무효(은정혹진전)9례。비소세포폐암방료후BF(t=6．282,P=0．000)、BV(t=5．230,P=0．000)、PH(t=3．954,P=0．009)치균교방료전명현강저。 VEGF양성표체조환자종류방료전후BF(t=5．222,P=0．000)、BV(t=4．121,P=0．006)、PH(t=3．654,P=0．013)강저치교VEGF음성표체조명현。동시방료후평개위유효조종류관주삼수BF(t=6．122,P=0．000)、BV (t=5．221,P=0．000)、PH(t=2．854,P=0．032)강저치균교무효조명현。 VEGF양성표체조비소세포폐암방료후완해솔교VEGF음성표체조고(χ2=8．145,P=0．004)。 ROC 분석결과표명종류혈류량 BF(AUC =0．827,P =0．000)、혈용량BV(AUC=0．887,P=0．000)불부AUC>0．5,차여AUC위0．5적곡선차이유통계학의의。결론：비소세포폐암방료전종류관주삼수중적BF、BV여VEGF대평개화예측비소세포폐암방료후근기료효유개치。
Objective: To study the post-radiotherapy efficacy evaluation and prediction value of CT perfusion pa-rameters and VEGF in non-small-cell lung carcinoma. Methods: Fifty-eight pathologically confirmed non-small-cell lung patients between April 2010 to November 2013 were enrolled in this study. All patients received CT perfusion scan for lung mass before and 4 weeks after radiotherapy, and all the pathological slices were performed VEGF staining. BV( blood vol-ume) , BF( blood flow) , MTT( mean transit time) , PS( permeability surface) , PH( peak height) were compared for each case before and after radiotherapy. Also the variation of these parameters between VEGF positive group and negative group were compared,meanwhile the variation of perfusion parameters and VEGF expression between partial or complete response ( PR or CR ) group and stable or progressive disease( SD or PD) group after radiotherapy were also compared. The receiver <br> operating characteristic curve ( ROC ) was used to evaluate the value of these parameters on prognosis evaluation. Results:Forty-nine cases were evaluated as partial or com-plete response group, the other 9 cases were evaluated as sta-ble or progressive disease 4 weeks after radiotherapy. BF( t=6.282,P=0.000)、BV(t=5.230,P=0.000)、PH(t=3. <br> 954,P=0. 009) significantly descended 4 weeks after radiotherapy. The descending value of BF(t=5. 222,P=0. 000)、BV(t=4.121,P=0.006)、PH(t=3.654,P=0.013)in VEGF positive group were obviously higher than that in VEGF negative group,and the descending value of BF(t=6. 122,P=0. 000)、BV(t=5. 221,P=0. 000)、PH(t=2. 854,P=0. 032) in the partial or complete response group were also higher than that in the stable or progressive disease group. The re-mission rate of VEGF positive group was higher than that of VEGF negative group. ROC analysis showed that BF(AUC=0. 827,P=0. 000)、BV(AUC=0. 887,P=0. 000)had statistically significant difference comparing with the AUC 0. 5 curve. Conclusion:The CT perfusion parameters, such as BF , BV and VEGF expression are useful in evaluating and predicting the near future therapeutic efficacy after radiotherapy in non-small-cell lung carcinoma.