Relevant Clinical And Imaging Predicors Of Metastatic Disease To The Brain From Non-small Cell Lung Carcinoma

Objective To investigate risk factors and impact on non-small cell lung cancer of brain metastases combining with imaging information and clinical data.Methods The relevant data of 272 non-small cell lung cancer patients with pathological diagnosed were retrospectively analyzed,including 78 patients with brain metastasis and 194 patients with non-brain metastases. SPSS17.0 statistical software was used for analysis. Multivariate Logistic regression analysis was applied to assess the influencing factors of brain metastasis and calculate the predicted probability, using ROC curve for analyzing the best diagnostic cutoff value, sensitivity and specificity.Results(1) Univariate analysis found that age, primary tumor histological type, degree of differentiation, T stage, N stage and related CT imaging features such as primary tumor morphology, pulmonary lymphangitis carcinomatous and pleural indentation may be the risk factors of non-small cell lung cancer with brain metastasis. Sex, primary tumor site and the primary tumor edge were not statistically significant.(2) Multivariate analysis showed that young patients, adenocarcinoma, poorly differentiated, N1-3 stage and pleural indentation of non-small cell lung cancer were independent influencing factors for patients with brain metastasis.(3) Probability prediction model: Logit(π) =- 4.609 + 1.458 × age + 1.317 × pathological type + 1.243 × differentiation-1.388 × N staging + 1.253 × pleural indentation. when thecut-off was 0.657, the sensitivity and specificity were 79.4%, 80.2% respectively; when the diagnostic cut-off was 0.628, the sensitivity and specificity were 81.3%, 75%; when the diagnostic cut-off was 0.665, the sensitivity and specificity were 78.5%, 79.2%.Conclusion Age≤ 60 years old, adenocarcinoma, poorly differentiated, N1-3stage, pleural indentation are the risk factors of brain metastasis from non-small cell lung cancer; T stage、Primary tumor morphology、pulmonary lymphangitis carcinomatous are the possible risk factors for brain metastasis.