早期肺癌进展趋势的影响因素和CT研判  

Factors Influencing the Progression Trend of Early Lung Cancer and CT Findings

作　　者：裘杨波 毛锋[1] 张辉[1] 申屠阳[1] Yangbo QIU;Feng MAO;Hui ZHANG;Yang SHEN-TU(Shanghai Chest Hospital,Shanghai JIaotong University~ Department of Thoracic Surgery,Shanghai Lung Tumor Clinical Medical Center,Shanghai 200030,China)

机构地区：[1]上海交通大学附属胸科医院/上海市肺部肿瘤临床医学中心,上海200030

出　　处：《中国肺癌杂志》2018年第10期793-799,共7页Chinese Journal of Lung Cancer

摘　　要：背景与目的不同类型的肺部结节具有不同的体积倍增时间(volume doubling time, VDT)。目前针对不同病理类型早期肺腺癌VDT的研究较少。本研究通过回顾性分析143例早期肺腺癌的影像资料,探讨早期肺腺癌的进展趋势及相关影响因素,为临床制订其随访策略提供参考。方法依据2015版世界卫生组织肺肿瘤分类标准和第8版肿瘤肿瘤-淋巴结-转移(tumor-node-metastasis, TNM)分期标准,对143例早期肺腺癌进行分类及分期。参考修正版Schwartz公式计算不同病理类型肺腺癌的VDT。结果 143例早期肺腺癌中,有50例(34.97%)出现进展,多因素分析显示影响因素包括随访时间、结节大小、病理类型、结节类型和病理分期。附壁生长为主型肺腺癌(lepidic predominant adenocarcinoma, LPA)的VDT为(594±272)d,伴少量附壁生长成分浸润性腺癌的VDT为(520±285)d,完全浸润性腺癌的VDT为(371±183)d,3类进展性早期肺腺癌的VDT有统计学差异(P=0.044)。结论在早期肺腺癌中,约有35%的肿瘤处于进展阶段,是否含有附壁生长成分是影响肿瘤进展速度的重要因素。Background and objective It has been known that the volume doubling time （VDT） of different lung nodule types is different. At present, there is still a lack of studies about the volume doubling time of lung cancer with different pathological types. The purpose of the study is to explore the factors influencing the progression of the early-stage adenocar- cinoma, and provide some reference for the follow-up strategy of lung nodules by retrospective analysis of the image data of 143 early-stage adenocarcinoma. Methods 143 cases of the early adenocarcinoma were dassified according to the 2015 World Health Organization Classification of Lung Tumors and the Eighth edition of the tumor-node-metastasis （TNM） classification of lung cancer.The volume doubling time was calculated with reference to the revised Schwartz formula. Results Among the 143 cases of the early adenocarcinoma, 50 cases （34.97%） were in progression. By multivariate analysis, there were several fac- tors associated with the progression of the early adenocarcinoma： the follow-up time, the dimension of nodule, the pathological type, the nodule type and the pathological stage. The VDT ofhpidic predominant adenocarcinoma （LPA） is （594±272） d. The VDT of the invasive adenocarcinoma with lepidic part, but not predominant, is （520±285） d. The VDT of the invasive adeno- carcinoma without lepidic part is （371±183） d. Conclusion About 35% of the early adenocarcinoma is in progress. Whether with the lepidic component is a positive factor to the speed of tumor progression.

关 键 词：附壁生长型肺腺癌 肿瘤进展 倍增时间 

分 类 号：R734.2[医药卫生—肿瘤]