肺神经内分泌肿瘤和鳞状细胞癌的CT诊断对比研究  

Comparative study of CT in the diagnosis of lung neuroendocrine tumors and squamous cell carcinoma

作　　者：艾散江·吐热普 赫娟[1] 古力吉热 张浩[1] 巴图尔·吐尔迪 AISANJIANG·Turepu;HAO Juan;GULIJIRE;ZHANG Hao;BATUER·Tuerdi(Department of Radiology ,the People's Hospital of Xinjiang Uygur Autonomous Region ,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院放射科,新疆乌鲁木齐830001

出　　处：《实用放射学杂志》2019年第8期1241-1244,共4页Journal of Practical Radiology

摘　　要：目的探讨肺神经内分泌肿瘤(NET)的CT表现,并与肺鳞状细胞癌(SCC)进行对照分析,以提高诊断正确率。方法选取经病理证实的肺NET 34 例和肺SCC 34例,回顾性分析患者临床特征及病变的CT表现,并对两者的CT表现进行比较。结果①肺NET形状不规则、远处转移、分叶征、胸腔积液及肿块有血管穿行出现率高于肺SCC组(χ^2=13.247、5.322、4.533、6.353、7.654,P<0.05);两者性别、年龄、部位、肿瘤边缘光整或毛糙、大血管受侵、毛刺征、胸膜凹陷、肿块伴钙化出现率差异无统计学意义(χ^2=2.378、0.587、0.657、0.706、0.236、0.405、0.360、0.657,P>0.05);肺SCC组肿瘤不均匀强化、囊变坏死、发生空洞、阻塞性肺炎及支气管闭塞出现率高于肺NET组(χ^2=22.835、9.316、6.476、10.019、5.322,P<0.05)。②Logistic回归分析显示,肿块呈分叶状(OR值=12.660,P=0.036)、远处转移(OR值=16.265,P=0.047)、肿块有血管穿行(OR值=17.159,P=0.026)是肺NET的危险因素,而肿瘤不均匀强化(OR值=0.007,P=0.001)和坏死及囊变(OR值=0.092,P=0.042)与肺NET呈负相关。结论肺NET与肺SCC在CT上具有相似性,需结合肿块有无分叶状改变、远处转移情况、肿块有无血管穿行、强化方式及坏死、囊变情况进行鉴别。Objective To investigate the CT manifestations of lung neuroendocrine tumor ( NET) and compare them with lung squamous cell carcinoma (SCC), to improve the diagnostic accuracy.Methods 34 cases of lung NET and 34 cases of lung SCC confirmed by surgery and pathology were enrolled in the study,and the clinical features and CT manifestations of the lesions were analyzed retrospectively and compared with each other.Results ① The incidence of irregular shape,distant metastasis,lobulation sign,pleural effusion and vascular penetration in the NET were higher than those in the SCC (χ^2=13.247, 5.322,4.533,6.353,7.654,P<0.05).There were no significant differences in the occurrence rate of sex, age, location, smooth or rough margin, invasion of large vessels, burr sign, pleural indentation,and calcification (χ^2=2.378, 0.587, 0.657,0.706 ,0.236 ,0.405,0.360,0.657,P>0.05).The occurrence rates of heterogenous enhancement,cystic necrosis,cavitation, obstructive pneumonia and bronchial occlusion in the SCC were higher than those in the NET (χ^2=22.835,9.316,6.476,10.019,5.322 ,P<C0.05).② Logistic regression analysis showed that lobulation (OR=12.660, P=0.036), distant metastasis (OR=16.265,P=0.047)and vascular passage (OR=17.159,P=0.026) were the risk factors for the NET, while the heterogeneous enhancement (OR=0.007,P=0.001), necrosis and cystic degeneration (OR=0.092 ,P=0.042) were negatively correlated with the NET.Conclusion Lung NET and lung SCC have similarties on CT, which should be differentiated according to the lobular changes,distant metastasis,vascular passage,enhancement and necrotic cystic degeneration.

关 键 词：肺肿瘤 神经内分泌肿瘤 鳞状细胞癌 计算机体层成像 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]