CT值鉴别纯磨玻璃密度的肺原位腺癌与微浸润腺癌的价值  

The CT Value in Differentiating Lung Adenocarcinoma in Situ(AIS) with Minimally Invasive Adenocarcinoma(MIA) Manifesting as Pure Ground-glass Opacity

作　　者：杨海 陈盈 李欣 郑海红 吴娟 王官良 樊树峰 谢继承 

机构地区：[1]台州恩泽医疗中心(集团)恩泽医院,浙江台州318500 [2]台州恩泽医疗中心(集团)台州医院,浙江台州317000

出　　处：《肿瘤学杂志》2017年第2期121-124,共4页Journal of Chinese Oncology

基　　金：浙江省台州市科技局A类项目(14SF03);浙江省自然科学基金(LY13H180010);浙江省医药卫生基金(2013KYA223)

摘　　要：[目的]探讨平扫CT值对表现为纯磨玻璃密度的肺原位腺癌(AIS)和微浸润腺癌(MIA)的鉴别诊断价值。[方法 ]回顾性分析表现为纯磨玻璃密度的肺原位腺癌32例、微浸润腺癌45例的术前资料,比较两组病例平扫CT值,并通过ROC曲线确定两组病例CT值的最佳截断点。[结果]原位腺癌与微浸润腺癌的CT值不同(-595.37±79.49Hu vs-497.62±121.08Hu;Z=-3.406,P<0.05),CT值对于原位腺癌与微浸润腺癌的诊断价值较好(曲线下面积0.729,95%CI:0.618~0.839,P<0.05),-491.55Hu为AIS与MIA的最佳CT值截断点(灵敏度为48.9%,特异性为93.7%)。[结论]平扫CT值对于肺原位腺癌和微浸润腺癌的诊断有一定指导意义,当CT值>-491.55Hu时,病灶为MIA可能性大;当CT值<-491.55Hu时,病灶为AIS可能性大。[Objective] To explore the CT value in differentiating lung adenocarcinoma in situ（AIS） with minimally invasive adenocarcinoma（MIA） manifesingt as pure ground-glass opacity,and to provide guidance for the diagnosis of AIS and MIA. [Methods] The preoperative CT data of 32 AIS and 45 MIA were analyzed retrospectively,compared their plain scan CT value,and found the best cut-off on ROC curve in the two groups. [Results] The CT value between AIS and MIA was different（-595.37 ±79.49 Hu vs-497.62 ±121.08 Hu,Z=-3.406,P〈0.05）,the CT value was a good indicator to distinguish AIS and MIA（area under the ROC was 0.729,95%CI：0.618~0.839,P〈0.05）,and the CT value of-499.51 Hu was the best cut-off for AIS and MIA（sensitivity was 48.9%,specificity was 93.7%）. [Conclusion] The CT value may be benefit to diagnosis the lung adenocarcinoma in situ（AIS） and minimally invasive adenocarcinoma（MIA） which manifested as pure ground-glass opacity.The lesion’CT value bigger than-499.51 Hu is more likely to be MIA;while the lesion’CT value smaller than-499.51 Hu is more likely to be AIS.

关 键 词：肺肿瘤 原位腺癌 微浸润腺癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]