MSCT增强征象联合血清VEGF-D、Cyfra21-1预测非小细胞肺癌纵隔淋巴结转移的价值研究OA

Objective To explore the predictive value of multi-slice spiral computed tomography(MSCT)enhancement features combined with serum vascular endothelial growth factor D(VEGF-D)and cytokeratin 19 fragment(Cyfra21-1)levels for mediastinal lymph node metastasis in non-small cell lung cancer(NSCLC).Methods Eighty NSCLC patients were divided into the metastatic group(n=32)and the non-metastatic group(n=48)based on surgical pathology results.All patients underwent MSCT enhancement scanning before surgery,and the short diameter,morphology,margin,enhancement pattern,and fusion of mediastinal lymph nodes were observed.Serum VEGF-D and Cyfra21-1 levels were also measured.Differences in MSCT enhancement features and serum marker levels between the two groups were compared,and Logistic regression was used to analyze risk factors for metastasis.The predictive performance of each indicator and combined detection was evaluated using ROC curves.Results In the metastatic group,lymph node short diameter ≥ 10 mm,irregular morphology,blurred margin,heterogeneous enhancement,fusion ratio,and serum VEGF-D and Cyfra21-1 levels were significantly higher than those in the non-metastatic group(P＜0.05).Multivariate Logistic regression analysis showed that lymph node short diameter ≥ 10 mm,irregular morphology,heterogeneous enhancement,and serum VEGF-D and Cyfra21-1 were independent risk factors for mediastinal lymph node metastasis in NSCLC(P＜0.05).ROC curve analysis revealed that the area under the curve(AUC)of combined detection was 0.932,with a sensitivity of 87.50％and a specificity of 91.67％,significantly higher than those of single indicator detection(P＜0.05).Conclusions The combination of MSCT enhancement features with serum VEGF-D and Cyfra21-1 detection can significantly improve the predictive accuracy of mediastinal lymph node metastasis in NSCLC,providing valuable reference for clinical treatment planning.