探究能谱CT在非小细胞肺癌纵隔淋巴结转移探查中的应用价值

杨昱; 肖文豪; 华秀丽; 夏厚栋; 吴阿敏; 丁甫成

doi:10.19732/j.cnki.2096-6210.2026.02.010

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探究能谱CT在非小细胞肺癌纵隔淋巴结转移探查中的应用价值

论著 | 更新时间：2026-05-07

- 探究能谱CT在非小细胞肺癌纵隔淋巴结转移探查中的应用价值
- Application value of energy spectrum CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer
- 肿瘤影像学 2026年35卷第2期页码：301-308
- 作者机构：
  
  1.青岛市第三人民医院放射科，山东青岛 266100
  2.康复大学青岛中心医院肿瘤科，山东青岛 266000
  3.康复大学青岛中心医院中西医科，山东青岛 266000
- 作者简介：
  
  DING Fucheng　E-mail: fortune_1980@163.com
- 基金信息：
  
  无
- DOI：10.19732/j.cnki.2096-6210.2026.02.010
  中图分类号： R734.2;R445.3
- 收稿：2025-08-29，
  
  修回：2026-01-05，
  
  纸质出版：2026-04-28
- 稿件说明：
移动端阅览
杨　昱, 肖文豪, 华秀丽, 等. 探究能谱CT在非小细胞肺癌纵隔淋巴结转移探查中的应用价值［J］. 肿瘤影像学, 2026, 35(2): 301-308.

YANG Y, XIAO W H, HUA X L, et al.Citation: Application value of energy spectrum CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer［J］. Oncoradiology, 2026, 35(2): 301-308.
杨　昱, 肖文豪, 华秀丽, 等. 探究能谱CT在非小细胞肺癌纵隔淋巴结转移探查中的应用价值［J］. 肿瘤影像学, 2026, 35(2): 301-308. DOI： 10.19732/j.cnki.2096-6210.2026.02.010.

YANG Y, XIAO W H, HUA X L, et al.Citation: Application value of energy spectrum CT in the detection of mediastinal lymph node metastasis in non-small cell lung cancer［J］. Oncoradiology, 2026, 35(2): 301-308. DOI： 10.19732/j.cnki.2096-6210.2026.02.010.

摘要

目的

探究能谱计算机体层成像（computed tomography，CT）在非小细胞肺癌（non-small cell lung cancer，NSCLC）纵隔淋巴结转移探查中的应用价值。

方法

回顾并分析2023年5月—2024年8月青岛市第三人民医院收治的NSCLC患者。根据病理学检查淋巴结转移情况分为淋巴结转移组和淋巴结未转移组，比较两组患者的一般资料。比较所有患者原发灶、淋巴结以及两组间能谱CT相关参数［能谱曲线斜率（energy spectrum curve slope，

）、标准化有序原子序数值（standardized ordered atomic value，

eff-Z

）、标准化碘密度（normalized iodine concentration，NIC）］的差异。采用受试者工作特征（receiver operating characteristic，ROC）曲线分析能谱CT对NSCLC转移的诊断价值。采用logistic二元回归方程分析前述指标与NSCLC纵隔淋巴结转移的相关性。

结果

纳入的105例NSCLC中，淋巴结转移组39例，淋巴结未转移组66例，淋巴结转移组原发肿瘤大小、临床分期、血清癌胚抗原（carcinoembryonic antigen，CEA）水平均高于淋巴结未转移组（

0.05）；105例患者淋巴结平扫及动脉期

、NIC均高于原发灶（

0.05）；平扫期淋巴结转移组淋巴结平扫及动脉期

、NIC均低于淋巴结未转移组（

0.05），平扫及动脉期

eff-Z

均高于淋巴结未转移组（

0.05）；ROC曲线分析显示，平扫

、

eff-Z

、NIC以及动脉期

、

eff-Z

、NIC的AUC为0.679~0.961（

0.05）。Logistic二元回归方程分析结果显示，原发肿瘤大小、临床分期、血清CEA水平及各项能谱CT相关参数均与NSCLC纵隔淋巴结转移阳性结果显著相关（

0.05）。

结论

平扫和动脉期

、

eff-Z

、NIC等能谱CT相关参数在临床中对NSCLC纵隔淋巴结转移具有预测价值。

Abstract

Objective

To explore the application value of energy spectrum computed tomography (CT) in the detection of mediastinal lymph node metastasis in non-small cell lung cancer (NSCLC).

Methods

Patients with NSCLC at the Third People’s Hospital of Qingdao from May 2023 to August 2024 were retrospectively analyzed

and they were divided into lymph node metastasis group and lymph node non-metastasis group according to the pathological results of lymph node metastasis. General data of patients

relative parameters of energy spectrum CT

such as energy spectrum curve slope (

)

standardized ordered atomic value (

eff-Z

)

normalized iodine concentration (NIC)

in primary lesions and lymph nodes of patients and between the two groups were compared. And receiver operating characteristic (ROC) curve was used to analyze its diagnostic value on NSCLC metastases. Logistic binary regression equation was used to analyze the correlation between the above indicators and mediastinal lymph node metastasis in NSCLC.

Results

Among 105 cases of NSCLC

there were 39 cases in lymph node metastasis group and 66 cases in lymph node non-metastasis group. The primary tumor size

clinical staging and serum carcinoembryonic antigen (CEA) level in lymph node metastasis group were higher than those in lymph node non-metastasis group (

0.05). The

and NIC in plain scan and in arterial phase of lymph nodes in 105 patients were higher than those of primary lesions (

0.05). The

and NIC of lymph nodes in plain scan and arterial phase in lymph node metastasis group were lower than those in lymph node non-metastasis group (

0.05) while the

eff-Z

values in plain scan and arterial phase were higher than those in lymph node non-metastasis group (

0.05). ROC curve results showed that the AUCs of

eff-Z

and NIC in plain scan and

eff-Z

and NIC in arterial phase ranged from 0.679 to 0.961 (

0.05). Logistic binary regression equation analysis revealed that the primary tumor size

clinical staging

serum CEA level and energy spectrum CT related parameters were significantly correlated with positive results of mediastinal lymph node metastasis in NSCLC (

0.05).

Conclusion

Energy spectrum CT parameters such as

eff-Z

and NIC in plain scan and arterial phase have clinical predictive value on mediastinal lymph node metastasis in NSCLC.

关键词

Keywords

references

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