纯磨玻璃密度肺腺癌内异常空气支气管征预测病理亚型的价值  

Abnormal air bronchogram within pure ground glass opacity lung adenocarcinoma： value for predicting histopathologic subtypes

作　　者：杨越清 高杰[3] 金梅[1] 罗春材 吴重重[1] 赵绍宏[1] 

机构地区：[1]解放军总医院放射诊断科,北京100853 [2]唐山工人医院放射科,063000 [3]解放军总医院病理科,北京100853

出　　处：《中华放射学杂志》2017年第7期489-492,共4页Chinese Journal of Radiology

基　　金：国家自然科学基金（81641068）;解放军总医院临床科研扶持基金（2016FC-TSYS-1025）

摘　　要：目的探讨纯磨玻璃密度结节（pGGN）肺腺癌内部异常空气支气管征在预测其病理分型的价值。方法回顾性分析我院2014年4月到2016年2月所有手术切除肺腺癌患者的影像资料，其中CT表现为pGGN的肺腺癌患者共157例患者（165个病灶），其中浸润前病变30个、微浸润腺癌（MIA）39个、浸润性腺癌（IAC）96个。记录病变位置、大小、CT值、异常空气支气管征。将病变按有无异常空气支气管征分为两组，采用χ2检验分析两组间病理亚型的差异；采用秩和检验分析两组间病变大小的差异；采用两个独立样本t检验分析两组间病变密度的差异。结果共有85个pGGN肺腺癌出现空气支气管征，其中浸润前病变12个、MIA 17个、IAC 56个。出现异常空气支气管征共61个，其中浸润前病变1个、MIA 13个、IAC 47个，两组间病理亚型的差异存在明显差异（χ2=25.943，P〈0.01）。无、有异常空气支气管征两组病变的平均直径分别为（10.8±4.2）、（17.0±6.7）mm，两组间直径差异有统计学意义（Z=－6.197，P〈0.01）；平均密度分别为（－519±118）、（－518±124）HU，两组间密度差异无统计学意义（t=－0.042，P=0.966）。结论pGGN肺腺癌内异常空气支气管征对病变的浸润性有一定预测价值。ObjectiveTo analyze the value of abnormal air bronchogram for predicting the invasiveness of lung adenocarcinoma with pure ground-glass nodule （pGGN）. MethodsFrom April 2014 to February 2016, 157 patients with 165 pGGN lung adenocarcinomas confirmed by surgical pathology were selected. There were 30 pre-invasive lesions （AAH＋AIS）, 39 minimally invasive adenocarcinoma （MIA）, and 96 invasive adenocarcinoma （IAC）. CT characteristics including lesion size, density, abnormal air bronchogram were recorded. All lesions were divided into two groups： normal group （no air bronchogram or normal air bronchogram） and abnormal air bronchogram group. Chi-square test was used to analyze the difference of pathological subtypes between the two groups. Mann-Whitney rank test was used to analyze the size difference of pGGN between the two groups. Two-independent samples t-test was used to analyze the lesion density difference of pGGN between the two groups. ResultsOf the 165 lesions, 85 were found to have air bronchogram, there were 12 lesions in 30 pre-invasive lesions （AAH＋AIS）, 17 in 39 MIAs, 56 in 96 IACs. Abnormal air bronchogram were demonstrated in 61 lesions which was 1 in 30 pre-invasive lesions （IACs＋AIS）, 13 in 39 MIAs and 47 in 96 IACs, significant differences were found between two groups （χ2=25.943, P〈0.01）. The mean size of the IACs were （10.8±4.2） mm for normal group, （17.0±6.7） mm for abnormal air bronchogram group, the mean density were （-519±118） HU and （-518±124） HU, respectively. There was a significant difference in lesion diameter between two groups （Z=-6.197, P〈0.01）, but not in density （t=-0.042, P=0.966）. ConclusionsAbnormal air bronchogram can be used to predict the invasiveness of pGGN lung adenocarcinoma, and is correlated with lesion size, but not with density.

关 键 词：肺肿瘤 纯磨玻璃密度结节 病理学 体层摄影术 X线计算机 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]