Application of CT Image Texture Analysis and Peripheral Blood Fibrinogen in Evaluating Chemotherapy Sensitivity in Non-small Cell Lung Cancer
XU Qiang
LI Zhijun
DUAN Na
QIN Yang
CHENG Xin
Abstract：Objective To investigate the value of combining CT image texture analysis and peripheral blood fibrinogen measurement in assessing the chemotherapy sensitivity of patients with non-small cell lung cancer(NSCLC).Methods A total of 116 patients diagnosed with NSCLC in Hebi Coal Industry(Group)Co.,LTD.General Hospital and received first-line chemotherapy from January 2021 to December 2023 were enrolled,each undergoing six chemotherapy cycles.One month after concurrent chemoradiotherapy,treatment outcomes were evaluated according to the response evaluation criteria in solid tumors.Thirteen patients with complete response and 51 patients with partial response were classified into the sensitive group(64 cases),while 23 patients with stable disease and 29 patients with progressive disease were classified into the resistant group(52 cases).One week prior to chemotherapy,clinical data were collected and fibrinogen levels were measured.All patients underwent contrast-enhanced chest CT,and texture analysis was performed on the tumor region to extract multiple texture features,such as gray-level co-occurrence matrix,gray-level non-uniformity,and contrast.Differences between groups were compared.Logistic regression was used to identify factors influencing chemotherapy sensitivity,and receiver operating characteristic(ROC)curve were constructed to evaluate predictive performance.Results There were no significant differences between the sensitive and resistant groups in terms of gender,smoking history,tumor location,histological type,age,and carcinoembryonic antigen(P＞0.05).Patients in the sensitive group had lower proportions of distant metastases and poor differentiation,as well as lower fibrinogen and cytokeratin 21-1 levels,compared with the resistant group(P＜0.05).There were no differences in the mean,variance,skewness,kurtosis,autocorrelation,and contrast in the sensitive and resistant patients with enhanced chest CT scans(P＞0.05).However,the sensitive group showed a higher maximum standardized uptake value(SUVmax)and lower energy and entropy(P＜0.05).Logistic regression and nomogram analyses indicated that cytokeratin 21-1,fibrinogen,energy,entropy,and SUVmax measured one week before chemotherapy all influenced chemotherapy sensitivity.A predictive model for chemotherapy resistance was established,yielding the area under the curve(AUC)of 0.910(95％CI:0.853-0.968),indicating good predictive value.Conclusion The CT image texture features of energy,entropy,and SUVmax,along with peripheral blood fibrinogen and cytokeratin 21-1 levels,jointly influence chemotherapy sensitivity in NSCLC patients.The constructed predictive model,which exhibits a high accuracy in identifying chemotherapy resistance,can guide the development of individualized treatment strategies and improve therapeutic efficacy and patient prognosis.
Keywords：non-small cell lung cancerchemotherapy sensitivityCT image texture analysisfibrinogenpredictive model
Publication Date：2026-07-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 2363-2367 )