Value of quantitative parameters of energy spectrum CT combined with NLR and CAR detection in pre-dicting recurrence and metastasis of non-small cell lung cancer after radical surgery
Value of quantitative parameters of energy spectrum CT combined with NLR and CAR detection in pre-dicting recurrence and metastasis of non-small cell lung cancer after radical surgery
Objective:To investigate the value of quantitative parameters of energy spectrum CT combined with NLR and CAR detection in predicting recurrence and metastasis of non-small cell lung cancer(NSCLC)after radical surgery.Methods:A total of 114 patients with NSCLC who received radi-cal resection in our hospital from January 2018 to June 2021 were selected as the study subjects.Preop-erative chest plain scan and double-phase enhanced scan were performed on the patients,and the effec-tive atomic number(Eff-Z),standardized iodine concentration(NICVP)at arterial stage,standardized iodine concentration(NICAP)at venous stage and iodine concentration difference(ICD)were recor-ded.Neutrophil and lymphocyte counts were detected by automatic blood cell analyzer,serum C-reac-tive protein levels were determined by immunoturbidimetry,serum albumin levels were determined by bromocresol green method,neutrophil/lymphocyte ratio(NLR)and C-reactive protein/albumin ratio(CAR)were calculated and recorded.The patients were followed up for 2 years to observe whether re-currence and metastasis occurred.Results:There was no significant difference in gender,age,BMI,fam-ily tumor history,smoking history and pathological types between NSCLC patients with and without postoperative recurrence and metastasis(P＞0.05).The proportion of patients with stage Ⅱ and lymph node metastasis in the recurrent and metastatic group was significantly higher than that in the non-recurrent and non-metastatic group(P＜0.05).The Eff-Z,NICVP,NICAP and ICD of patients with postoperative recurrence and metastasis were significantly lower than those without recurrence and metastasis(P＜0.05),while NLR and CAR were significantly higher than those without recur-rence and metastasis(P＜0.05).Multivariate Logistic regression analysis showed that TNM stage,lymph node metastasis,Eff-Z,NICAP,NLR and CAR levels were independent influencing factors for postoperative recurrence and metastasis in NSCLC patients(P＜0.05).The Logistic regression equa-tion was established as follows:Logit(P)=-0.179+1.211 × TNM stage+1.161 × lymph node me-tastasis+(-0.209)× Eff-Z+(-0.368)×NICAP+0.842 × NLR+0.934 × CAR.ROC curve analysis results showed that the area under the curve of the established model for predicting postoperative re-currence and metastasis of NSCLC patients was 0.958(95％CI:0.920～0.997,P＜0.001),and the sen-sitivity and specificity were 92.0％and 85.4％,respectively,which was better than the prediction effi-cacy of each indicator alone.Conclusion:The combined application of clinicopathological features,quan-titative parameters of energy spectrum CT,NLR and CAR detection is effective in predicting recur-rence and metastasis of NSCLC after radical surgery,and has certain clinical application value.
维普
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