肺癌患者65例化疗前后CT影像学变化及疗效评估价值研究

目的观察肺癌患者65例化疗前后CT影像学的变化,探讨其在评估化疗疗效中的应用价值。方法选取医院收治的非小细胞肺癌患者65例作为研究对象,均经纤支镜或穿刺组织病理学确诊,肺鳞癌选择长春瑞滨联合顺铂方案化疗,腺癌及大细胞癌选择培美曲塞联合顺铂方案化疗。分析化疗疗效并对比化疗前后CT影像学变化。结果本组65例肺癌患者中,13例CR,17例PR,15例SD,20例PD。总缓解率为45.15%;两组治疗前后60s、25s时CT值高于0s(P0.05);缓解组化疗后0s、25s、60s时相应的CT密度显著低于未缓解组化疗后,差异显著(P0.05);化疗前37例中央型肺癌表现为支气管内可见软组织密度影,管壁增厚,管腔不规则狭窄,12例伴随肺不张;28例周围型肺癌肺内存在软组织肿块影,呈圆形或不规则状,边缘不光滑,8例可见纵膈和淋巴结肿大。化疗后复查CT,缓解组肺癌患者肿块缩小,边界不清晰,9例肺不张打开。结论多层螺旋CT动态扫描可作为评估肺癌化疗疗效的重要影像学方式之一。

A Study on CT Imaging Changes Before and After Chemotherapy and Efifcacy Evaluation Value in 65 Patients with Lung Cancer

Objective To investigate CT imaging changes before and after chemotherapy in 65 patients with lung cancer and to explore its application value in evaluating the efficacy of chemotherapy. Methods 65 patients with non-small cell lung cancer in the hospital were selected as the research objects. All were confirmed by fiberoptic bronchoscopy or puncture histopathology. Vinorelbine combined with cisplatin chemotherapy was chosen for treating lung squamous carcinoma while pemetrexed combined with cisplatin chemotherapy for adenocarcinoma and large cell carcinoma. The curative effect of chemotherapy was analyzed and the CT imaging changes were compared before and after chemotherapy. Results Among the 65 patients with lung cancer in this group, there were 13 cases with CR, 17 cases with PR, 15 cases with SD and 20 cases with PD. The total remission rate was 45.15%. The CT values at 60s and 25s before and after the treatment were higher than that at 0s (P<0.05). After chemotherapy, the corresponding CT density at 0s, 25s and 60s in the relief group was significantly lower than that of the non relief group and the difference was significant (P<0.05). Before chemotherapy, 37 cases of central lung cancer manifested as visible soft tissue density shadows in bronchus, the wall thickening, lumen irregular stenosis and 12 cases complicated with pulmonary atelectasis. There were soft tissue mass shadows in lungs of 28 cases with peripheral lung cancer, which were round or irregular, with rough edges. There was mediastinum and lymphadenectasis in 8 cases. After chemotherapy, with CT reexamination, the masses in patients with lung cancer in the relief group were shrinked, with unsharp boundaries. 9 cases were with pulmonary atelectasis opening. Conclusion Multi slice spiral CT dynamic scan can be used as an important imaging method for evaluating the efficacy of chemotherapy for lung cancer.