基于18F-FDG PET/CT代谢参数、临床特征分析非小细胞肺癌纵隔淋巴结转移的影响因素OA
Analysis of the influencing factors of mediastinal lymph node metastasis in non-small cell lung cancer based on 18F-FDG PET/CT metabolic parameters and clinical characteristics
目的:分析非小细胞肺癌(NSCLC)合并纵隔淋巴结转移(MLNM)的影响因素.方法:收集 2023 年 1 月—2025 年 1月我院接受治疗的NSCLC患者 248 例,根据是否合并MLNM将其分为MLNM组(73 例)和无MLNM组(175 例).本研究采用对照分析的方法,首先对比两组病例的基线资料及 18F-FDG PET/CT显像的代谢参数差异.随后运用多因素Logistic回归模型筛选独立危险因素,并建立相应的回归方程.最后通过ROC曲线评估回归方程的诊断效能,计算曲线下面积(AUC)以验证其预测准确性.结果:中央型肿瘤、肿瘤实性比例≥80%、原发灶最大径大、肿瘤代谢体积(MTV)高、原发灶最大标准化摄取值(SUVmax)高、病灶糖酵解总量(TLG)高、原发灶SUVmax 与纵隔血池SUVmean 的比值(SURblood)高、原发灶SUVmax 与肝脏SUVmean 的比值(SURliver)高是NSCLC合并MLNM的独立危险因素(P<0.05).构建回归方程:logit(P)=-7.432+肿瘤分型×0.879+胸肿瘤实性比例×1.032+原发灶最大径×0.657+MTV×0.980+原发灶SUVmax×1.114+病灶TLG×0.879+SURblood×0.987+SURliver×0.687.ROC曲线显示,当logit(P)>0.21 时,AUC值及χ2 分别为 0.876、17.257,诊断敏感度和特异度分别为 87.67%、74.86%.结论:NSCLC合并MLNM的独立危险因素包括中央型肿瘤、肿瘤实性比例≥80%、原发灶最大径大、MTV高、原发灶SUVmax 高、病灶TLG高、SURblood高、SURliver 高,据此构建的回归方程的预测价值较高.
Objective:To analyze the influencing factors of mediastinal lymph node metastasis(MLNM)in non-small cell lung cancer(NSCLC).Methods:NSCLC patients who received treatment at the Affiliated Hospital of Xuzhou Medical University were included in the study from January 2023 to January 2025.The clinical data of 248 patients were retrospectively ana-lyzed.They were divided into the MLNM group(73 cases)and the non MLNM group(175 cases)based on whether they had MLNM.This study adopted a control analysis method.Firstly,the differences of the baseline data and metabolic parameters of 18F-FDG PET/CT imaging between the two groups were compared.Then,a multivariate Logistic regression model was used to screen independent risk factors and establish the corresponding regression equation.Finally,the diagnostic efficacy of the re-gression equation was evaluated through the ROC curve,and the area under the curve(AUC)was calculated to verify its pre-dictive accuracy.Results:Central type tumors,tumor solid proportion≥80%,large primary lesion diameter,high tumor metabolic volume(MTV),high primary lesion maximum standardized uptake value(SUVmax),high lesion total glycolysis(TLG),high ratio of SUVmax of the primary lesion to the mediastinal blood pool SUVmean(SURblood),and high ratio of SUVmax of the primary le-sion to the liver SUVmean(SURliver)were independent risk factors for NSCLC with MLNM(P<0.05).Construct regression equation:logit(P)=-7.432+tumor classification×0.879+solid proportion of chest tumor×1.032+maximum diameter of primary lesion×0.657+MTV×0.980+SUVmax of primary lesion×1.114+TLG of lesion×0.879+SURblood×0.987+SURliver×0.687.The ROC curve showed that when logit(P)>0.21,the AUC value and χ2 were 0.876 and 17.257,respectively,the diagnostic sensitivity and specificity were 87.67%and 74.86%,respectively.Conclusion:The independent risk factors of NSCLC with MLNM included central type tu-mors,tumor solid proportion≥80%,large primary lesion diameter,high MTV,high primary lesion SUVmax,high lesion TLG,high SURblood,and high SURliver.The regression equation constructed based on this had high predictive value.
吴仪仪;庞建鑫;王伟
徐州医科大学附属医院医学影像科,江苏 徐州 221000徐州医科大学附属医院医学影像科,江苏 徐州 221000徐州医科大学附属医院医学影像科,江苏 徐州 221000
医药卫生
癌,非小细胞肺肿瘤转移纵隔肿瘤正电子发射断层显像计算机体层摄影术
Carcinoma,Non-Small-Cell LungNeoplasm MetastasisMediastinal NeoplasmsPositron Emission Tomography Computed Tomography
《中国临床医学影像杂志》 2026 (5)
323-327,5
徐州市科技项目(KC23328).
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