目的探讨晚期非小细胞肺癌CT 灌注参数在疗效评价中的价值及其与表皮 生长因子受体(EGFR)表达的相关性。方 法 收集45例在靶向治疗前后的晚期非小 细胞肺癌患者CT灌注参数，所有患者均经 病理证实。患者依据EGFR表达情况分为阳 性组(n=37)和阴性组(n=8)，依据疗效分 为缓解者(n=25)和未缓解者(n=20)。分析 血流量(BF)、血容量(BV)、毛细血管通透 性(PMB)与EGFR表达的相关性，比较靶向 治疗前后各灌注参数值的变化与疗效的关 系。结果 各CT灌注参数与晚期非小细胞 肺癌是否存在EGFR表达无关(P>0.05)；缓 解组的BF明显高于未缓解组(P<0.05)；靶 向治疗前后缓解组BF、PMB值均有显著下 降，未缓解组靶向治疗前后对比BF、BV值 均有上升(P<0.05)；将BF值下降认为靶向 治疗达到缓解，CT灌注参数预测RECIST评 价有效的敏感性、特异性、阳性预测值及 阴性预测值分别为100%、85%、84.51%及 100%。结论 CT灌注参数有助于评价晚期 非小细胞肺癌靶向治疗效果。

Objective To explore the value of CT perfusion indexes in evaluating therapeutic effect and relationship with expression of epidermal growth factor (EGFR) in patients with advanced non-small cell lung cancer (NSCLC). Methods CT perfusion indexes of before-and-after treatment in 45 patients with advanced NSCLC were collected. All patients were confirmed by pathology. Patients were divided into positive group (n=37) and negative group (n=8) according to the expression of EGFR. Besides, remission (n=25) and no-remission group (n=20) were divided according to the therapeutic effect. The correlation between the expression of EGFR and indexes, including blood flow (BF), blood volume (BV) and permeability(PMB), were analyzed. Moreover, the correlation between therapeutic effect and changes of each indexes were compared. Results CT perfusion indexes have no correlation with the expression of EGFR in advanced NSCLC (P>0.05). BF value in remission group was apparently higher than that in no-remission group (P>0.05). BF and PMB values were declined dramatically in remission group whereas BF and BV values were increased in no-remission group (P>0.05). Considering the decline of BF value as effective treatment, the sensitivity, specificity, positive predictive and negative predictive value of CT perfusion indexes were 100%, 85%, 84.51% and 100%, respectively. Conclusion CT perfusion indexes can contribute to the evaluation of therapeutic effectin advanced NSCLC.