摘要
目的:探讨64层螺旋CT灌注(CTP)成像联合血清microRNA(miR)-20a、miR-210水平对非小细胞肺癌(NSCLC)同步放化疗预后的预测价值。方法:回顾性分析105例行同步放化疗的NSCLC患者的临床资料,同步放化疗结束2周后评估疗效,行CT检查并记录血流量(BF)、表面通透性(PMB)、对比剂平均通过时间(MTT),实时荧光定量PCR法检测血清miR-20a、miR-210水平。结果:同步放化疗结束2周后,缓解84例,未缓解21例。随访1 a,生存68例,死亡37例。缓解组BF、PMB及血清miR-20a、miR-210水平低于未缓解组,生存组低于死亡组(P<0.05);缓解组MTT长于未缓解组,生存组长于死亡组(P<0.05)。Logistic回归分析结果显示BF、PMB、MTT、血清miR-20a、miR-210水平是预后不良的预测因子,OR(95%CI)分别为2.599(1.856~3.341)、2.100(1.748~2.452)、1.831(1.236~2.427)、3.117(2.197~4.038)、2.892(2.004~3.380)。5个指标在诊断界点串联预测的灵敏度、准确度、约登指数分别为72.97%、94.12%、0.671。结论:CTP成像参数BF、PMB、MTT及血清miR-20a、miR-210水平与NSCLC同步放化疗预后关系密切,指标联合可提高预后预测的特异度。
Aim:To analyze the value of 64 multi-slice spiral CT perfusion(CTP)imaging combined with serum microRNA(miR)-20a and miR-210 for the prognosis evaluation of concurrent chemoradiotherapy of non-small cell lung cancer(NSCLC).Methods:The clinical data of 105 patients with NSCLC treated with concurrent radiotherapy and chemotherapy were retrospectively analyzed.Two weeks after the end of the concurrent chemoradiotherapy course,CTP imaging was carried out and the parameters,such as blood flow(BF),surface permeability(PMB),mean transit time of contrast medium(MTT)were recorded,and the serum levels of miR-20a,miR-210 were determined by qRT-PCR.Results:A total of 84 cases obtained remission after concurrent chemoradiotherapy,and 68 cases were survival during 1 year follow-up.BF,PMB and serum miR-20a,miR-210 levels of the remission group were lower than those of the non-remission group,and the above parameters of the survival group were lower than those of the death group(P<0.05);MTT of the remission group was longer than that of the non-remission group,and MTT of the survival group was longer than that of the death group(P<0.05).The results of logistic regression showed that BF,PMB,MTT,serum levels of miR-20a,miR-210 were the prediction indexes for the prognosis,and OR(95%CI)was 2.599(1.856-3.341),2.100(1.748-2.452),1.831(1.236-2.427),3.117(2.197-4.038),2.892(2.004-3.380),respectively.The sensitivity,accuracy,and Jordan index of the tandem detection of BF,PMB,MTT,and serum miR-20a and miR-210 levels for prognosis assessment were 72.97%,94.12%,and 0.671.Conclusion:The levels of CTP imaging parameters BF,PMB,MTT and the expression levels of serum miR-20a and miR-210 are closely related to the prognosis of concurrent chemoradiotherapy of NSCLC,and the combined detection can improve the specificity of prognosis evaluation.
作者
潘元威
董军强
胡丽丽
王猛
周志刚
PAN Yuanwei;DONG Junqiang;HU Lili;WANG Meng;ZHOU Zhigang(Department of Radiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2020年第2期281-286,共6页
Journal of Zhengzhou University(Medical Sciences)
作者简介
通信作者:周志刚,男,1966年10月生,硕士,主任医师,教授,研究方向:胸腹部影像学诊断及微创介入治疗;E-mail:283546210@qq.com。
