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目的探讨16层首过时间动态增强CT评价周围型非小细胞肺癌(NSCLC)血管生成及其病理学特征的价值。方法33例周围型NSCLC患者行首过时间动态CT检查,记录首过时间强化峰值(PH),采用CD34免疫组化(S-P法),测定微血管密度(MVD),评价首过时间PH值与MVD的相关性。结果33例患者首过时间PH值及MVD不同N分期(N0与N1-2组)间差异有统计学意义(P<0.01),首过时间PH值与MVD呈正相关(r=0.793,P=0.000)。首过时间PH值判断NSCLC有无淋巴结转移(N0与N1-2)的最佳界值点为12 HU,利用该界值点判断N分期的敏感度、特异度、准确率、阳性和阴性预测值分别为88.0%、75.0%、84.8%、91.7%和66.7%。结论肺部首过时间动态增强CT有在活体替代MVD评价周围性非小细胞肺癌病理学特征的能力,首过时间PH值可能成为常规CT对NSCLC分期的有效补充。
Objective To investigate the value of dynamic contrast-enhanced 16-slice first-pass dynamic CT in angiogenesis and pathological features of peripheral non-small cell lung cancer (NSCLC). Methods Thirty-three patients with peripheral NSCLC underwent dynamic CT scan. The first peak time (PH) was recorded. The CD34 immunohistochemistry (SP method) was used to determine the microvessel density (MVD) Relevance. Results There were significant differences between the first episode of PH and MVD in N stages (N1 and N2) (P <0.01), and the positive correlation between PH and MVD (r = 0.793, P = 0.000). The best value of the first time PH value to determine the presence or absence of lymph node metastasis (N0 and N1-2) of the best cut-off point of 12 HU, the use of the cut-off point to determine the sensitivity, specificity, accuracy, positive and negative predictive value of N staging The values were 88.0%, 75.0%, 84.8%, 91.7% and 66.7% respectively. Conclusion The first dynamic lung CT scan has the ability to evaluate the pathological features of peripheral non-small cell lung cancer in vivo instead of MVD. The first passage time PH value may be an effective complement to conventional CT in the staging of NSCLC.