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CT 影像大数据辅助动脉化疗栓塞联合~(125)I 粒子植入治疗非小细胞肺癌的预后评估。

Prognostic Evaluation of CT Imaging Big Data-Assisted Arterial Chemoembolization Combined with I Seed Implantation for Non-Small-Cell Lung Cancer.

机构信息

Sixth Medical Center of PLA General Hospital, Beijing 100048, China.

China-Japan Friendship Hospital, Beijing 100048, China.

出版信息

Comput Math Methods Med. 2022 Jul 13;2022:3472982. doi: 10.1155/2022/3472982. eCollection 2022.

Abstract

OBJECTIVE

To investigate the prognostic impact of computed tomography (CT) imaging big data-assisted arterial chemoembolization combined with iodine 125 (I) seed implantation on patients with non-small-cell lung cancer (NSCLC).

METHODS

A total of 116 patients with intermediate and advanced NSCLC hospitalized in our hospital from August 2019 to August 2020 were selected and divided into a control group and an experiment group (58 cases in each group) by random number table method for the study. The patients in the experiment group were treated with CT imaging big data-assisted arterial chemoembolization combined with I seed implantation, while the patients in the control group were treated with arterial chemoembolization alone, with the use of gemcitabine combined with cisplatin (GP) in chemotherapy. The prognostic impact was determined by analyzing recent efficacy; the incidence of adverse effects; tumor size and CT perfusion parameters including blood volume (BV), blood flow (BF), and permeability surface (PS); frailty state and quality of life; and the levels of serum tumor markers including carcinoembryonic antigen (CEA), glycoconjugate antigen 125 (CA125), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), microRNA- (miRNA-) 137, and miR-379-5p. In addition, frailty status was evaluated using the Fried frailty phenotype (FP) scale, and quality of life was determined according to Karnofsky Performance Status (KPS) score. Kaplan-Meyer (KM) method was used to analyze the survival rate of NSCLC patients after a 12-month follow-up.

RESULTS

The remission rate in the experiment group (77.59%) was higher than that in the control group (56.90%) ( < 0.05). Tumor size, BV, BF, PS, serum CEA and CA125 levels, and FP value in both groups were dramatically reduced after treatment compared with before treatment, especially in the experiment group after 1 and 3 months of treatment ( < 0.05). Meanwhile, the serum miR-137 and miR-379-5p levels and KPS scores in both groups were higher after treatment than before treatment, especially in the experiment group after 1 and 3 months of treatment ( < 0.05). However, there was no significant difference in the incidence of nausea and vomiting, alopecia, diarrhea, myelosuppression, and hemoptysis of NSCLC patients in both groups after treatment ( > 0.05). Further, the 12-month survival rate of NSCLC patients was higher in the experiment group (84.21%) than in the control group (64.29%) ( < 0.05).

CONCLUSION

CT imaging big data-assisted arterial chemoembolization combined with I seed implantation for NSCLC can improve recent efficacy and the prognosis of NSCLC patients by inhibiting tumor progression with a certain degree of safety.

摘要

目的

探讨计算机断层扫描(CT)影像大数据辅助动脉化疗栓塞联合碘 125(I)种子植入术对非小细胞肺癌(NSCLC)患者的预后影响。

方法

选取 2019 年 8 月至 2020 年 8 月我院收治的 116 例中晚期 NSCLC 患者,采用随机数字表法将其分为对照组和试验组(每组 58 例)。试验组患者采用 CT 影像大数据辅助动脉化疗栓塞联合 I 种子植入术治疗,对照组患者采用单纯动脉化疗栓塞治疗,化疗采用吉西他滨联合顺铂(GP)方案。通过分析近期疗效;不良反应发生率;肿瘤大小和 CT 灌注参数,包括血容量(BV)、血流(BF)和通透性表面(PS);虚弱状态和生活质量;以及血清肿瘤标志物,包括癌胚抗原(CEA)、糖链抗原 125(CA125)、细胞角蛋白 19 片段抗原 21-1(CYFRA21-1)、微小 RNA-(miRNA-)137 和 miR-379-5p 的水平,确定预后影响。此外,采用弗里德虚弱表型(FP)量表评估虚弱状态,根据卡诺夫斯基表现状态(KPS)评分评估生活质量。采用 Kaplan-Meier(KM)法分析 NSCLC 患者 12 个月随访后的生存率。

结果

试验组的缓解率(77.59%)高于对照组(56.90%)(<0.05)。与治疗前相比,两组患者的肿瘤大小、BV、BF、PS、血清 CEA 和 CA125 水平以及 FP 值均显著降低,尤其是治疗后 1 个月和 3 个月时的试验组(<0.05)。同时,两组患者的血清 miR-137 和 miR-379-5p 水平以及治疗后 KPS 评分均高于治疗前,尤其是治疗后 1 个月和 3 个月时的试验组(<0.05)。然而,两组 NSCLC 患者治疗后恶心呕吐、脱发、腹泻、骨髓抑制和咯血的发生率差异无统计学意义(>0.05)。此外,试验组 NSCLC 患者 12 个月生存率(84.21%)高于对照组(64.29%)(<0.05)。

结论

CT 影像大数据辅助动脉化疗栓塞联合 I 种子植入术治疗 NSCLC 可通过抑制肿瘤进展,在一定程度上提高 NSCLC 患者的近期疗效和预后,且安全性较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a88/9300324/779c9283f4f6/CMMM2022-3472982.001.jpg

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