肺黏液表皮样癌14例CT影像特征与组织学分级相关性初步研究  

CT features of 14 cases of pulmonary mucoepidermoid carcinoma and correlation with pathological grading

作　　者：王定君 李鲁[1] 潘江峰[1] 舒锦尔[1] 陈晓荣[1] 夏秀梅 刘立恒 魏生彩 李文武 WANG Ding-jun;LI Lu;PAN Jiang-feng;SHU Jin-er;CHEN Xiao-rong;XIA Xiu-mei;LIU Li-heng;WEI Sheng-cai;LI Wen-wu(Department of Imaging,Jinhua Central Hospital,Jinh.ua 321000,P.R.China;Department of Diagnostic Radiology,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,P.R.China;Department of Imaging,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,P.R.China)

机构地区：[1]金华市中心医院医学影像科,浙江金华321000 [2]复旦大学附属中山医院放射诊断科,上海200032 [3]山东省肿瘤防治研究院(山东省肿瘤医院)影像科,山东第一医科大学(山东省医学科学院),山东济南250117

出　　处：《中华肿瘤防治杂志》2019年第16期1196-1199,1207,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：浙江省基础公益研究计划(LGF18H180011)

摘　　要：目的原发性肺黏液表皮样癌(pulmonary mucoepidermoid carcinoma,PMEC)发病率较低,生物学行为具有一定特殊性,准确诊断是制定合理治疗方案的关键前提.本研究旨在分析PMEC的CT特征,并探讨其与PMEC病理组织学分级的相关性.方法回顾性分析2011-01-01-2018-05-01复旦大学附属中山医院收治的14例PMEC患者临床及影像资料.研究病变大小、发生位置、与支气管关系、边缘特征、钙化、增强情况、阻塞改变和转移情况等CT特征,并依据组织学结果,将患者分为低级别组(5例)和高级别组(9例),进一步评估CT特征与组织学分级的相关性.结果 14例PMEC中,发生在大气道和周围肺者各占50.0%;最大径10~81 mm,平均33 mm;病灶边缘光整者占28.6%(4/14),不光整者占71.4%(10/14);约21.4%(3/14)病灶出现钙化;增强后无强化或轻微强化占42.9%(8/14),中度以上强化57.1%(8/14);双肺、骨等远处转移占21.4%(3/14),区域淋巴结转移占21.4%(3/14),无转移占57.1%(8/14).增强特征在低级别组与高级别组PMEC间差异有统计学意义,P=0.031.结论 PMEC典型CT表现为支气管内、管腔周围或肺门区的圆形、卵圆形或浅分叶肿物,境界清楚,远端可见阻塞性改变;与低级别PMEC相比,高级别肿瘤更多表现为中度及以上强化.OBJECTIVE Pulmonary mucoepidermoid carcinoma(PMEC) is a rare disease with distinct biological behavior. Accurate pretreatment diagnosis is a key premise for decision-making. This study aimed to evaluate CT features of PMEC and to investigate their association with histopathologic grading of PMEC. METHODS The imaging,clinical and pathological data of PMEC patients (treated in Zhongshan Hospital Affiliated to Fudan University between Jan 1st,2011 and May 1st, 2018) were retrospectively reviewed. CT features including tumor size, location, relationship to bronchus, margin, calcification, enhancement, obstructive changes and metastasis were analyzed. Furthermore, cases were divided into low-grade group and high-grade group according to the histological results, and the distribution of all CT features were compared between the two groups. RESULTS Out of the enrolled 14 cases,50. 0% located in central airway and the other half located within peripheral lung,size ranged from 10 mm to 81 mm with a mean size of 33 mm,28. 6%(4/14) showed well-defined margin and 71. 4%(10/14) with irregular margin. On the post-contrast images,42. 9%(6/14) lesions showed mild or no enhancement while 57. 1%(8/14) showed medium or obvious enhancement. 21. 4%(3/14) of the patients had distant metastasis,21. 4%(3/14) only had nodal involvement and 57. 1 %(8/14) without metastasis. Of all the CT features we observed,only enhancement status was associated with pathological grading of PMEC(P=0. 031). CONCLUSIONS On CT images,PMEC typically presents as a round,oval or superficial lobular mass within or around bronchus or hilar region, with obstructive change of the distal lung. Compared with low-grading PMEC, high-grading tumor more frequently shows a medium or obvious enhancement.

关 键 词：支气管肿瘤 黏液表皮样癌 肺 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤]