肺癌伴肺内单发小结节的良恶性研究  

Small solitary pulmonary nodule coexisting with primary lung cancer on CT:benign versus malignant

作　　者：张文玉[1] 黄勇[1] 申洪明[1] 李文武[1] 

机构地区：[1]山东省肿瘤防治研究院CT室,济南250117

出　　处：《放射学实践》2012年第8期852-855,共4页Radiologic Practice

摘　　要：目的:探讨原发性肺癌的临床分期、原发灶与肺内单发小结节的位置关系对诊断结节良恶性的价值。方法:回顾性分析113例原发性肺癌伴肺内单发结节患者的CT资料,分析肺癌的临床分期,观察肺内单发结节与肺癌原发灶的位置关系,并分析良恶性结节的特点。结果:113个结节中38个恶性,Ⅰ期肺癌肺内结节恶性可能性较其它期低(P=0.032)。与原发灶位于同侧肺的结节较对侧肺结节为恶性的可能性大(P=0.012),且为恶性转移结节的可能性大(P<0.001);与原发灶位于同一肺叶的结节也较其它肺叶为恶性的可能性大(P=0.018),其中与原发灶距离≤2cm的结节较>2cm者为恶性的可能性大(P=0.033),且均为转移性结节;同叶内距离原发灶>2cm且<5cm者较≥5cm者为恶性的可能性大(P=0.026)。结论:肺癌患者的临床分期、肺内单发结节位置、原发灶同一叶内的结节距原发灶的距离远近与结节性质均有一定关系,距原发灶2cm以内的小结节高度提示为恶性。Objective： To investigate the probability of malignancy in small solitary pulmonary nodule （S-SPN） coexisting with primary lung cancer （PLC） in terms of associated factors such as clinical stage,and location of S-SPN and PLC. Methods：The preoperative CT scans of 113 patients with PLC were retrospectively reviewed. The probability of malig- nancy of coexisting S-SPNs was evaluated based on nodule size, location, and clinical stage of PLC. Results： Of the 113 S- SPNs,38 were malignant. Malignant S-SPNs were significantly fewer in clinical stage-I patients than in the patients with the other stages （P=0. 032）. The probability of malignancy of S-SPNs within PLC lung was significantly higher than that in the contralateral lung （P=0. 012）. The probability of metastasis of S-SPNs within PLC lung was significantly higher than that in the eontralateral lung （P〈0.01）. The probability of malignancy of S-SPNs within PLC lobe was significantly higher than that in the other lobes （P=0. 018）. The probability of malignancy of S-SPNs within 2cm of PLCs was signifi- candy higher than that more than 2cm away from PLCs （P = 0. 012）, and these S-SPNs were metastatic nodules. The proba- bility of malignancy of S-SPNs 〉 2cm and 〈5cm away from PLCs was significantly higher than that ≥ 5cm away from PLCs （P= 0. 026）. Conelusion：CT can demonstrate the probability of malignancy in S-SPN coexisting with PLC in terms of associated factors such as clinical stage,and location of S-SPN and PLC. Small solitary nodule within 2cm from the primary carcinoma is highly suggestive of malignancy.

关 键 词：肺肿瘤 诊断 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]