磨玻璃样密度肺腺癌脏层胸膜浸润的相关影像因素分析  

Correlation analysis of preoperative imaging characteristics with visceral pleural invasion in lung adenocarcinoma presented with ground glass opacity

作　　者：丁红豆 史景云[2] 周晓[1] 谢冬[1] 陈林松[1] 王海峰[1] 

机构地区：[1]同济大学附属上海市肺科医院胸外科,上海200433 [2]同济大学附属上海市肺科医院影像科,上海200433

出　　处：《外科研究与新技术》2016年第2期111-114,117,共5页Surgical Research and New Technique

基　　金：上海市科委科技基金(15411965400)

摘　　要：目的分析磨玻璃密度(ground glass opacity,GGO)肺腺癌CT特征与脏层胸膜浸润的关系。方法选择2013年9月—2014年10月接受手术治疗且术后病理证实为腺癌的740例肺部GGO,其中脏层胸膜浸润组84例,无浸润组656例,分析其与CT特征之间的关系。结果患者年龄、GGO类型、GGO最大直径、实性成分直径、实性成分比例、距胸膜最小距离、胸膜凹陷征、边缘和形状均与脏层胸膜浸润情况有关,多因素logistic回归分析显示GGO最大直径>12 mm、实性成分直径>5 mm、距胸膜最小距离<6 mm、胸膜凹陷征和粗糙边缘是脏层胸膜浸润的危险因素(OR=3.23、4.41、3.58、2.21和2.65),联合以上5个因素判别浸润情况的曲线下面积(area under curve,AUC)达到0.861。结论术前CT特征用于判别表现为GGO的肺腺癌的脏层胸膜浸润情况有重要价值。Objective To investigate the correlation of CT characteristics with visceral pleural invasion in lung adenocarcinoma presented with ground glass opacity（GGO）. Methods A total of 740 cases of GGO undergoing surgery between September 2013 and October 2014 with conformation as adenocarcinoma by postoperative pathological examinations were selected. Among them,there were 84 cases with visceral pleural invasion,and there was no invasion in the other 656 cases. The correlation of CT characteristics with visceral pleural invasion was analyzed. Results Age,GGO types,the maximum whole diameter,the diameter of consolidation,the proportion of consolidation,the minimum distance from lesions to pleura,pleural retraction,margins and shape were significantly related to visceral pleural invasion. Multivariate logistic regression analysis showed the maximum whole diameter 〉12 mm,the diameter of consolidation〉 5 mm,the minimum distance from lesions to pleura 6 mm,pleural retraction and nonsmooth margin were risk factors for visceral pleural invasion（OR=3.23,4.41,3.58,2.21,2.65）. The area under the receiver operating characteristic curve of multivariate analysis model was 0.861. Conclusion Preoperative CT findings play an important role in evaluating visceral pleural invasion in lung adenocarcinoma presented with GGO.

关 键 词：磨玻璃密度 CT 脏层胸膜浸润 

分 类 号：R734.2[医药卫生—肿瘤]