动态对比增强磁共振成像定量参数联合血清SCC-Ag预测肺癌脑转移瘤预后的价值-东南大学学报医学版

动态对比增强磁共振成像定量参数联合血清SCC-Ag预测肺癌脑转移瘤预后的价值

单位：邢台医专第二附属医院 CT-MRI科, 河北邢台 054000

关键词：动态对比增强磁共振成像定量参数鳞状上皮细胞癌抗原肺癌脑转移瘤危险因素联合检测预测价值

分类号：R739.41

出版年·卷·期（页码）：2025·44·第二期（306-312）

摘要：

目的:探讨动态对比增强磁共振成像定量参数联合血清鳞状上皮细胞癌抗原(SCC-Ag)预测肺癌脑转移瘤预后的价值。方法:回顾性分析2019年1月至2022年6月我院收治的97例肺癌伴有脑转移瘤患者的临床资料,患者经相关治疗后随访记录1年。根据患者预后情况将97例患者分为良好组(61例)和不良组(36例)。对比良好组与不良组患者血管外细胞外间隙容积比(Ve)、容量转移常数(K^trans)、速率常数(Kep)以及血清SCC-Ag水平,采用多因素Logistic回归分析肺癌脑转移瘤患者预后不良的主要影响因素,并且运用ROC曲线分析联合检测对肺癌脑转移瘤预后不良的预测价值。结果:与不良组比较,良好组患者Ve、K^trans、Kep以及血清SCC-Ag水平较低(P<0.05);多因素Logistic回归分析显示,脑转移瘤数量≥4个、血清SCC-Ag、有其他部位发生病灶和转移、Kep、脑转移瘤最大直径≥3 cm、Ve、K^trans均是肺癌脑转移瘤患者不良预后的影响因素(P<0.05);ROC曲线显示,与Ve、Kep、K^trans、血清SCC-Ag单项检测相比,联合检测的预测价值更高(P<0.05)。结论:动态对比增强磁共振成像定量参数联合血清SCC-Ag对肺癌脑转移瘤患者的不良预后具有一定的预测价值,且脑转移瘤数量≥4个、血清SCC-Ag、有其他部位发生病灶和转移、Kep、脑转移瘤最大直径≥3 cm、Ve、K^trans均是预后不良的主要危险因素。

Objective: To study the value of dynamic contrast-enhanced magnetic resonance imaging quantitative parameters combined with serum squamous cell carcinoma antigen(SCC-Ag) in predicting the prognosis of lung cancer brain metastases. Methods: Clinical data of 97 patients with lung cancer accompanied by brain metastases admitted to our hospital from January 2019 to June 2022 were retrospectively analyzed. After treatment, the follow-up was recorded for 1 year. According to the results of follow-up, 97 patients were divided into good group and bad group, 61 patients in good group and 36 patients in bad group. The extracellular space volume ratio(Ve), volume transfer constant(K^trans), rate constant(Kep) and serum SCC-Ag levels in the good group and the bad group were compared, and the main factors affecting the poor prognosis of lung cancer patients with brain metastases were analyzed by multivariate Logistic regression. The ROC curve analysis was used to predict the poor prognosis of lung cancer brain metastases. Results: Compared with the bad group, the levels of Ve, K^trans, Kep and serum SCC-Ag in the good group were lower(P<0.05); Multivariate Logistic regression analysis showed that the number of brain metastases ≥4, serum SCC-Ag, lesions and metastases in other sites, Kep, maximum diameter of brain metastases ≥3 cm, Ve and K^trans were the main factors affecting the adverse prognosis of lung cancer patients with brain metastases(P<0.05). ROC curve showed that combined detection of Ve, Kep, K^trans and serum SCC-Ag had higher predictive value than those of single detection(P<0.05). Conclusion: Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging combined with serum SCC-Ag have certain predictive value for poor prognosis of lung cancer brain metastasis patients, and the number of brain metastasis≥4, serum SCC-Ag, lesions and metastasis in other sites, Kep, brain metastasis maximum diameter≥3 cm, Ve, K^trans are the main risk factors affecting the poor prognosis of lung cancer patients with brain metastases.

参考文献：

[1] 侯伟良,吕中华,郑宏山,等.非小细胞肺癌脑转移瘤综合治疗的预后影响因素分析[J].现代生物医学进展,2020,20(1):176-180.
[2] 吴永晖,吴文杰,傅文凡,等.lncRNA POLG-DT在非小细胞肺癌新辅助化疗耐药患者组织中高表达并促进癌细胞增殖、迁移和侵袭[J].现代肿瘤医学,2023,31(16):2983-2988.
[3] 郝之月,高阳,吴琼,等.MAP-MRI与DCE-MRI在鉴别胶质母细胞瘤与脑转移瘤中的应用价值[J].磁共振成像,2023,14(2):12-20.
[4] HENDRIKS L E,KERR K M,MENIS J,et al.ESMO Guidelines Committee.Electronic address:clinicalguidelines@esmo.org.Oncogene-addicted metastatic non-small-cell lung cancer:ESMO Clinical Practice Guideline for diagnosis,treatment and follow-up[J].Ann Oncol,2023,34(4):339-357.
[5] HUANG Q,LIU L,XIAO D,et al.CD44+ lung cancer stem cell-derived pericyte-like cells cause brain metastases through GPR124-enhanced trans-endothelial migration[J].Cancer Cell,2023,41(9):1621-16368.
[6] 黎嘉敏,区杰浩,李晓丹,等.对比增强磁敏感加权成像序列与肺癌脑转移瘤检出的相关性[J].中国医学物理学杂志,2022,39(5):556-561.
[7] 施小珍,郭晓娟.基于MRI影像学检查研究肺癌脑转移瘤与病理类型的关系[J].中国CT和MRI杂志,2021,19(10):49-51.
[8] 古兰白尔·买买提,古力吉热·太来提,巴图尔·吐尔地,等.动态对比增强磁共振成像技术在脑胶质瘤诊断中的应用及对微血管的评估价值分析[J].中国CT和MRI杂志,2023,21(8):23-25.
[9] 杨学宁,吴一龙.实体瘤治疗疗效评价标准-RECIST[J].循证医学,2004,4(2):7.
[10] LIU W,POWELL C A,WANG Q.Tumor microenvironment in lung cancer-derived brain metastasis[J].Chin Med J(Engl),2022,135(15):1781-1791.
[11] AHN M J,KIM H R,YANG J C H,et al.Efficacy and Safety of Brigatinib Compared With Crizotinib in Asian vs. Non-Asian Patients With Locally Advanced or Metastatic ALK-Inhibitor-Naive ALK+ Non-Small Cell Lung Cancer:Final Results From the Phase III ALTA-1L Study[J].Clin Lung Cancer,2022,23(8):720-730.
[12] 别克木拉提·马合木提,依丽努尔·依力哈木,哈热勒哈什·安曼太.动态对比增强磁共振成像技术在头颈部淋巴结良恶性鉴别诊断中的临床价值[J].中国医学装备,2018,15(10):44-47.
[13] SHIN S U,CHO N,KIM S Y,et al.Time-to-enhancement at ultrafast breast DCE-MRI:potential imaging biomarker of tumour aggressiveness[J].Eur Radiol,2020,30(7):4058-4068.
[14] 孙素芳,孟静,刘琳.动态对比增强磁共振成像定量参数与半定量参数评估晚期肺癌患者放化疗敏感性的价值分析[J].癌症进展,2022,20(1):52-55.
[15] NISSAN N,ANABY D,MAHAMEED G,et al.Ultrafast DCE-MRI for discriminating pregnancy-associated breast cancer lesions from lactation related background parenchymal enhancement[J].Eur Radiol,2023,33(11):8122-8131.
[16] 禹海贺,赵亚影,屈娟娟,等.经阴道彩色多普勒超声、动态对比增强磁共振成像联合血清DKK1、CA724、NLR对子宫内膜癌的诊断价值研究[J].中国CT和MRI杂志,2023,21(7):147-150.
[17] 周彦汝,张岚,韩鼎盛,等.基于MRI影像组学构建新辅助放化疗后局部进展期直肠癌的预测模型[J].中国医学影像学杂志,2022,30(9):881-888.
[18] 司亚克,吕梦果,陈东东.非小细胞肺癌脑转移瘤患者血清CY21-1、SCC-Ag水平变化及其检测价值分析[J].实用癌症杂志,2023,38(3):427-430.
[19] 郑良建,荣丽雯,袁梦珍,等.血清PLR、NLR、GSTP1、SCC-Ag联合检测对非小细胞肺癌的预后价值分析[J].国际检验医学杂志,2021,42(16):1987-1991.
[20] TORIGOE R,OSHIKIRI T,GOTO H,et al.Prognostic impact of squamous cell carcinoma antigen during neoadjuvant chemotherapy for patients with esophageal squamous cell carcinoma treated with minimally invasive esophagectomy[J].Anticancer Res,2024,44(12):5485-5493.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录