间变淋巴瘤激酶阳性肺腺癌临床及CT影像特征  

Clinical and CT imaging characteristics in ALK rearranged lung adenocarcinoma

作　　者：苏宁[1] 李磊[1] 金韵 方伟军[2] 张贤兰[1] 谢亚琳[1] 黄智昊 岑文昌[1] SU Ning;LI Lei;JIN Yun;FANG Weijun;ZHANG Xianlan;XIE Yalin;HUANG Zhihao;CEN Wenchang(Department of Oncology,Guangzhou Chest Hospital,Guangzhou 510095,China;Department of Radiology,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院肿瘤科,广东广州510095 [2]广州市胸科医院放射科,广东广州510095

出　　处：《分子影像学杂志》2019年第2期172-176,共5页Journal of Molecular Imaging

基　　金：吴阶科医学基金会临床科研专项资助基金项目(320.6799.15007)

摘　　要：目的分析肺腺癌中间变淋巴瘤激酶(ALK)基因与临床及CT影像特征的关系。方法回顾性分析217例肺腺癌患者,其中ALK重排肺腺癌为ALK阳性组,根据性别及吸烟史从ALK阴性肺腺癌患者中1:1匹配为对照组,比较临床及CT影像特征,包括年龄、性别、吸烟史、分期以及位置、大小、毛玻璃改变、分叶征、毛刺征、同一肺叶结节、非同一肺叶结节、阻塞性肺炎、血管侵犯、坏死、胸膜牵拉征、支气管充气征、透亮征、淋巴结肿大、胸腔心包积液。结果 217肺腺癌患者中ALK阳性患者占12.9%(28/217),ALK阳性肺腺癌患者多见于年轻(47.93±13.68岁vs 59.75±13.27岁,t=3.281,P=0.002)、女性(46.4%vs 28.0%,χ~2=3.859,P=0.048)、非吸烟(67.9%vs 47.6%,χ~2=3.995,P=0.046)患者。ALK阳性肺腺癌胸部CT影像特征中血管侵犯(39.3%vs 14.3%,χ~2=4.462,P=0.035)和坏死(32.1%vs 3.6%,χ~2=7.791,P=0.005)更为常见,而其他影像特征在ALK阳性及阴性肺腺癌患者间差异无系统学意义(P>0.05)。结论年轻、非吸烟、女性且伴有血管侵犯和坏死典型CT影像特征的肺腺癌患者可能预测ALK基因阳性。Objective To explore clinical and CT characteristics of anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma.Methods In this retrospective study,217 lung adeno carcinoma patients were included.Patients with ALKrearrange were defined with ALK positive group,while the control group was matched by gender and smoking history from ALK negative lung adenocarcinoma patients.Four clinical features (age,gender,smoking history and staging) were recorded.The location,size,ground glass opacity,lobulation,spiculation,nodules in the same lobe,nodules in non-same lobe,obstructive pneumonia,vascular invasion,necrosis,pleural retraction,obstructive changes,bubble-like lucency,lymphadenopathy,pleural or pericardial effusion were analyzed.The items were compared between 28 ALK positive lung adeno carcinoma patients and ALK negative patients.Results In 217 lung adeno carcinoma patients,the positive rate of ALK was 12.9%(28/217).ALK positive patients were more common in younger (47.93±13.68 years vs 59.75±13.27 years,t=3.281,P=0.002),female (46.4% vs 28.0%,χ^2=3.859,P=0.048),non-smoking patients (67.9% vs 47.6%,χ^2=3.995,P=0.046).Vascular invasion (39.3% vs 14.3%,χ^2=4.462,P=0.035) and necrosis (32.1% vs 3.6%,χ^2=7.791,P=0.005)were higher in ALK positive lung adeno patients.Other CT imaging traits of two groups was not significantly different (P>0.05).Conclusion The patient may have ALK rearrange,whoyoung,female,non-smoking lung adenocarcinoma and accompanied with vascular invasion and necrosis in CT imaging.

关 键 词：肺腺癌 间变性淋巴瘤激酶 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]