T1a期肺腺癌CT征象与病理对照研究  

T1a Stage Lung Adenocarcinomas: CT Features and Pathological Findings

作　　者：陈相猛[1] 郝以秀 李荣岗[2] 黄列彬 张朝桐[1] 龙晚生[1] 

机构地区：[1]中山大学附属江门医院放射科,江门529070 [2]中山大学附属江门医院病理科,江门529070

出　　处：《临床放射学杂志》2016年第10期1502-1506,共5页Journal of Clinical Radiology

摘　　要：目的探讨T1a期肺腺癌的CT影像学特征与病理的关系。方法搜集74例经手术切除、病理确诊Ⅰa期肺腺癌病例。查阅文献确定肺腺癌的常见CT征象(包括瘤肺界面、毛刺征、分叶征、空泡征、胸膜凹陷征),由两位具有10年以上胸部疾病影像诊断经验的医师盲法共同阅片,对照分析肺腺癌结节CT征象与病理结果,应用方差分析、卡方检验对结果进行统计。结果 (1)Ⅰa期肺腺癌纯磨玻璃结节42例(56.8%),混合磨玻璃结节21例(28.4%),实性结节11例(14.9%)。(2)Ⅰa期肺腺癌中非典型腺瘤样增生11例(14.9%),原位腺癌8例(10.8%),微浸润型腺癌31例(41.9%),浸润型腺癌24例(32.4%)。(3)非典型腺瘤样增生、原位腺癌及微浸润型腺癌多是纯磨玻璃结节(37/50),浸润型腺癌以混合磨玻璃结节及实性结节为多(19/24)。(4)Ⅰa期肺腺癌瘤肺界面、毛刺征、分叶征、空泡征及胸膜凹陷征在4种病理类型的Ⅰa期肺腺癌中的分布差异均有统计学意义(P<0.01)。(5)4种病理类型的Ⅰa期肺腺癌大小差异具有统计学意义(P<0.01)。结论Ⅰa期肺腺癌中纯磨玻璃肺结节提示非典型腺瘤样增生及原位腺癌,随着结节增大及密度增高,浸润型腺癌的可能性增加。瘤肺界面清晰、毛刺征、分叶征、空泡征及胸膜凹陷征提示肺结节可能是浸润型腺癌。Objective To investigate the relationships between CT features and pathological findings of different pathological T1 a stage lung adenocarcinomas. Methods Collect 74 cases of patients who underwent curative resection and pathological diagnosis of lung adenocarcinomas from 1 January 2013 to 1 January 2015. Review the literatures and get the common CT features of lung adenocarcinomas（ including lung tumor interface,spiculation,lobulation,pleural indentation sign and bubble sign）. Two chest radiologists who have at least 10 years＇ experience were chosen to read the CT images without knowledge of the pathological results. Then compare the CT features with pathological results,including analysis of variance and chi-square test used for statistical results. Results（ 1） The stage Ⅰ a lung adenocarcinomas consisted of14. 9%（ 11 /74） atypical adenomatous hyperplasias,10. 8%（ 8 /74） adenocarcinomas in situ,41. 9%（ 31 /74） micro-invasive adenocarcinomas and 32. 4%（ 24 /74） invasive adenocarcinomas.（ 2） The stageⅠa lung adenocarcinomas consisted of 56. 8%（ 42 /74） pure ground-glass lung nodules,28. 4%（ 21 /74） mixed ground-glass nodules and 14. 8%（ 11 /74） solid nodules.（ 3） The pure GGNs mainly consisted of atypical adenomatous hyperplasias,adenocarcinomas in situ and microinvasive adenocarcinomas（ 37 /50）. The solid nodules and the mixed ground-glass nodules consisted of invasive adenocarcinomas（ 19 /24）.（ 4） There were significant differences in the lung tumor interface,lobulation,speculation,bubble sign and pleural indentation sign in four stage Ia lung adenocarcinomas（ P〈0. 01）.（ 5） There were significant differences in the size of four stage Ia lung adenocarcinomas（ P〈0. 01）. Conclusion The pure ground-glass nodules consisted of atypical adenomatous hyperplasias and adenocarcinomas in situ for stageⅠa lung adenocarcinomas. The possibility of invasive adenocarcinomas increases as the nodule size and density increases. The clear lung-tumor i

关 键 词：体层摄影术 X线计算机 非典型腺瘤样增生 原位腺癌 微浸润型腺癌 浸润型腺癌 

分 类 号：R734.2[医药卫生—肿瘤]