安罗替尼治疗前后非小细胞肺癌患者锁骨上转移淋巴结超声影像特征分析

目的:对比分析安罗替尼治疗前后晚期非小细胞肺癌转移锁骨上淋巴结内部血流超声影像特征的变化,探讨超声影像的疗效评估价值。方法:回顾性分析2019年2月至11月在上海交通大学附属胸科医院确诊并接受安罗替尼治疗的31例晚期非小细胞肺癌患者资料,观察患者经过安罗替尼治疗2个周期后,锁骨上转移淋巴结超声下二维及彩色多普勒的前后特征变化,并做相关性分析。结果:安罗替尼治疗后,患者的锁骨上淋巴结血流收缩期峰值流速(peak systolic velocity, PSV)明显下降(12.8 cm/s vs 7.5 cm/s),差异有统计学意义(P=0.006)。治疗前,患者锁骨上淋巴结血流分级中3级患者为38.7%,2级为12.1%,1级为18.2%,0级为29.0%,治疗后,3级患者降为16.1%,0级患者上升为41.9%,差异具有统计学意义(P=0.029)。关于血流分型,治疗前,29.0%的患者锁骨上淋巴结无血流分布,中央型、边缘型、混合型分别为19.4%、3.2%、48.4%。治疗后,患者锁骨上淋巴结血流混合型占比降为22.6%(P=0.001),无血流型占比升为41.9%。结论:安罗替尼对转移性锁骨上淋巴结血流的作用直接而有效,锁骨上淋巴结的大小及血流特征改变可作为超声诊断肺癌近期疗效的判定指标。

Ultrasound image characteristic analysis of non-small cell lung cancer patients with supraclavicular lymph node metastasis before and after treatment with anlotinib

Objective: To analyze the blood flow characteristics of the supraclavicular lymph nodes metastasis in patients with advanced non-small cell lung cancer by color Doppler ultrasound, these patients were treated with anlotinib as an anti-angiogenic drug, and therefore to provide help for lung cancer patients to evaluate the curative effect of the drug. Methods: From February 2019 to November 2019, clinical data of 31 advanced non-small cell lung cancer patients in the Chest Hospital, Shanghai Jiao Tong University treated with anlotinib were analyzed retrospectively. The two-dimensional color Doppler ultrasonography characteristics of the metastatic lymph nodes on the clavicle before and after two cycles of anlotinib treatment were compared and the correlation was analyzed. Results: The peak systolic velocity (PSV) of supraclavicular lymph node blood flow in patients after the treatment with anlotinib decreased significantly (12.8 cm/s vs 7.5 cm/s), and the difference was statistically significant (P=0.006). Before the treatment, the blood flow classification of supraclavicular lymph nodes in patients with anlotinib was 38.7%, 12.1%, 18.2% and 29.0% in patients with level 3.1% and 41.9% in patients with level 0, and the difference was statistically significant (P=0.029). Before the treatment, 29.0% of the patients had no blood flow distribution in supraclavicular lymph nodes, and 19.4%, 3.2% and 48.4% in central, marginal, and mixed types, respectively. After treatment with anlotinib the proportion of mixed blood flow pattern in supraclavicular lymph nodes decreased to 22.6%(P=0.001) and that of non-blood flow pattern increased to 41.9%. Conclusions: As an antiangiogenic drug, anlotinib has a direct and effective effect on the blood flow of metastatic supraclavicular lymph nodes. The changes of the size and blood flow characteristics of supraclavicular lymph nodes can be used as a criterion for the short-term efficacy of ultrasound in the diagnosis of lung cancer.