Based On The Theory Of "protective Field" Of Traditional Chinese Medicine, The Effect Of The Proportion Of Relatively Low Metabolic Area Of ??primary Lung Cancer On The Prognosis Of Patients Was Discussed

Object:To screen and analyze the factors related to the prognosis of lung cancer,and to find out the relative low metabolism area with the function of traditional Chinese medicine "nursing field"in the tumor by using PET/CT imaging technology,and analyze its influence on the survival time of the patients,to quantify and visualize it,and to provide further theoretical basis for the improvement of the clinical treatment strategy of lung cancer.Methods:(1)The clinical data of 107 patients with primary lung cancer and the results of 18F-FDGPET/CT imaging before treatment were collected.By measuring the 18F-FDG metabolism index SUV and SUL,the PET/CT post-processing software was used to calculate the GTV and the metabolic volume MTV of the tumor,and the ratio of the total volume of the tumor to the total volume of the tumor was calculated.(2)Retrospective analysis of the clinical and imaging data of 107 patients with primary lung cancer,the total median survival and total survival rate,and the gender,age,pathological classification,clinical stage,treatment,tumor peripheral immune cell infiltration,tumor SUVmax,tumor volume,tumor relative low metabolic area.The total volume percentage of the tumor was used as the independent variable,the survival outcome was used as the survival outcome,the survival time and the survival outcome were used as the dependent variable.The single factor analysis was carried out by Kaplan-Meier.Then the respective variables were further stratified by Log rank,and the variance analysis was used to compare the differences of the related indexes between each group.Sex,18 cases of peripheral immune cell infiltration in the tumor were analyzed separately,and the factors of P<0.05 were screened out in the results of single factor analysis,and the multiple factor analysis was carried out by the Cox proportional risk regression model.P<0.05 had statistical significance.Results:(1)Consistency analysis of metabolic parameters in patientsThe results of SUVpeak-automatic measurement of lung cancer lesions were Og/ml and 100%,and the SUVpeak-manual of lung cancer was significantly influenced by the operator.The results of the same doctor at different time and in different doctors were different;the processing software automatically measured the influence of the SUVpeak-automatic avoidance operator.Avoid the interference of empty tissue and inflammatory tissue,and ensure the accuracy and repeatability of the results.(2)Single factor analysis of each variableThe survival time of the male patients is longer than that of the female patients;with the clinical stage close to the late stage,the survival time of the patients is obviously reduced;the operation treatment can prolong the patient's survival time better;the survival time of the patient can be prolonged with the immune cell infiltration around the tumor;with the increase of SUVmax,the patient's survival time is obviously reduced;With the increase of tumor volume,the survival time of patients is significantly reduced.The larger the ratio of tumor low metabolism to total volume,the longer survival time.(3)Stratified analysis of various clinical stages:The survival time of patients undergoing surgical treatment in early and middle and late stages was significantly longer than those of untreated patients;with the clinical stages approaching late stage,the volume of the tumor was significantly increased,in the middle and late stages,with the increase of tumor volume and the increase of SUVmax,the survival time of the patients decreased significantly;the early and middle and late tumors were relatively low metabolic areas.Patients with a ratio of more than 50%can get longer survival time than other patients.(4)Stratified analysis of different surgical methods:In patients undergoing surgery,the earlier the preoperative clinical stage was,the better the patient's survival time was prolonged;for patients who had not received surgical treatment,the early and late stage of the clinical stage had no significant effect on the prolongation of the patient's survival time;the tumor volume of the patients undergoing surgical treatment was significantly lower than that of the unacceptable surgical treatment.However,the size of the tumor was not significantly affected by the size of the surgical treatment group or in the non operative treatment group.In the patients who were not treated,the patient's survival time decreased significantly with the increase of the SUVmax of the metabolic activity of the patients;the tumor was relatively low in metabolism.Patients with a ratio of more than 50%can receive longer survival time than any other patients,whether or not undergoing surgery.(5)Stratified analysis of different tumor volumeThe patients with tumor size less than 120cm3 were selected to receive surgical resection for longer survival time,and the larger tumor size(>120cm3)had lost the operation opportunity and the operation was the benefit of the patients.With the increase of tumor volume,the tumor SUVmax also increased significantly,only in the tumor volume.In the range of 17-119.9cm3,the changes in SUVmax can affect the survival time of the cancer patients;the number of tumors in the relative low metabolic area of the tumor is more than 50%,which can prolong the patient's survival time.(6)Stratification analysis of tumor relative low metabolic areaMore than 50%of the relative low metabolic regions of the tumor were in the clinical period,whether or not they were operated on.The survival time of the tumor was longer than that of the relative low metabolic area of the tumor less than 50%.The infiltration of the peripheral immune cells in the tumor appeared in the patients with more than 50%of the tumor relative to the lower metabolic area,and could bring the tumor to the patient more long life time.(7)Results of multi factor analysisCOX regression showed that there was statistical significance between Chi square 2=85.919 and P=0.000.Among all the variables,there were significant differences in the survival of the patients:sex(P=0.056),age(P=0.053),treatment(P=0.033),tumor SUVmax(P=0.021),immune cell infiltration(P=0.024)around the tumor,and the proportion of tumor relative low metabolic area(P=0),and SUVmax(RR=1.621,3.391).For risk factors,with the increase of SUVmax standardization perturbation value,more risk of death will be brought,while surgical treatment(RR=0.575),immune cell infiltration(RR=0.461)and tumor relative low metabolic area ratio(RR=0.206)are protective factors.The lesion is localized in immune cell infiltration,and the lesion is relatively low.The metabolic area accounts for more than 50%of the total lesion volume,making it possible for patients to benefit more.(8)Analysis of 18 patients with infiltration of immune cellsThe total median survival time of the 18 patients with peripheral immune cell infiltration was 20 ± 1.50 months,and the early patients had longer survival time,and the patients with relatively low metabolic areas were more than 50%,and the survival time was longer than those of less than 50%of the low metabolic area.Conclusions:(1)The percentage of the gross tumor volume corresponding to the gross tumor volume minus the volume of MTV(40%SUVmax)represents the range of the relative low metabolic area in the tumor.It is found that the range of the tumor is more than 50%of the gross tumor,which can effectively improve the patient's survival time.(2)The factors affecting the survival time of the patients,SUVmax is a risk factor,with the increase of SUVmax standardized intake value,it will bring more risk of death;the surgical treatment,the presence of immune cell infiltration and the proportion of the tumor relative to the low metabolic area are protective factors,the focal lesion of the lesion is immune cell infiltration,and the focus is in the lesion.The relative low metabolic area accounts for more than 50%of the total lesion volume,making the patients benefit more.