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肺癌患者 CT 灌注成像:鳞癌与腺癌的血流表现不同。

CT Perfusion in Patients with Lung Cancer: Squamous Cell Carcinoma and Adenocarcinoma Show a Different Blood Flow.

机构信息

DISI (Department of Computer Science and Engineering), University of Bologna, Viale Risorgimento 2, Bologna 40136, Italy.

ARCES (Advanced Research Center on Electronic Systems), University of Bologna, Via Toffano 2/2, Bologna 40125, Italy.

出版信息

Biomed Res Int. 2018 Sep 3;2018:6942131. doi: 10.1155/2018/6942131. eCollection 2018.

Abstract

OBJECTIVES

To characterize tumour baseline blood flow (BF) in two lung cancer subtypes, adenocarcinoma (AC) and squamous cell carcinoma (SCC), also investigating those "borderline" cases whose perfusion value is closer to the group mean of the other histotype.

MATERIALS AND METHODS

26 patients (age range 36-81 years) with primary Non-Small Cell Lung Cancer (NSCLC), subdivided into 19 AC and 7 SCC, were enrolled in this study and underwent a CT perfusion, at diagnosis. BF values were computed according to the maximum-slope method and unreliable values ( arising from artefacts or vessels) were automatically removed. The one-tail Welch's t-test (-value <0.05) was employed for statistical assessment.

RESULTS

At diagnosis, mean BF values (in [mL/min/100g]) of AC group [(83.5 ± 29.4)] are significantly greater than those of SCC subtype [(57.0 ± 27.2)] (-value = 0.02). However, two central SCCs undergoing artefacts from vena cava and pulmonary artery have an artificially increased mean BF.

CONCLUSIONS

The different hemodynamic behaviour of AC and SCC should be considered as a biomarker supporting treatment planning to select the patients, mainly with AC, that would most benefit from antiangiogenic therapies. The significance of results was achieved by automatically detecting and excluding artefactual BF values.

摘要

目的

对两种肺癌亚型(腺癌和鳞状细胞癌)的肿瘤基线血流(BF)进行特征描述,同时还研究了那些“边界”病例,它们的灌注值更接近另一种组织型的组平均值。

材料和方法

本研究纳入了 26 名患有原发性非小细胞肺癌(NSCLC)的患者(年龄范围 36-81 岁),分为 19 名腺癌和 7 名鳞状细胞癌患者,并对其进行了 CT 灌注检查。BF 值是根据最大斜率法计算的,并且自动去除了不可靠的(因伪影或血管引起的)值。采用单侧 Welch's t 检验(-值<0.05)进行统计学评估。

结果

在诊断时,腺癌组的平均 BF 值([mL/min/100g])[(83.5 ± 29.4)]明显大于鳞状细胞癌亚型[(57.0 ± 27.2)](-值=0.02)。然而,有两个中央的鳞状细胞癌由于静脉和肺动脉的伪影而具有人为增加的平均 BF。

结论

腺癌和鳞状细胞癌的不同血液动力学行为应被视为支持治疗计划的生物标志物,以选择主要患有腺癌的患者,他们将从抗血管生成治疗中获益最大。通过自动检测和排除伪影 BF 值,实现了结果的显著性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4212/6140241/a72878a230ff/BMRI2018-6942131.001.jpg

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