纯磨玻璃肺小腺癌内异常空气支气管征与病理亚型的相关性  

Correlation between abnormal air bronchograms and pathological subtypes in small lung adenocarcinoma with pure ground glass nodule

作　　者：黄定品 傅钢泽[1] 项益岚 纪晓微 蔡蒙婷 陈钱 刘萍萍 卢山珊[2] 杨运俊[1] HUANG Dingpin;FU Gangze;XIANG Yilan;JI Xiaowei;CAI Mengting;CHEN Qian;LIU Pingping;LU Shanshan;YANG Yunjun(Department of Radiology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,P.R.China;Department of Pathology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,P.R.China)

机构地区：[1]温州医科大学附属第一医院放射科,浙江温州325015 [2]温州医科大学附属第一医院病理科,浙江温州325015

出　　处：《医学影像学杂志》2019年第12期2047-2050,共4页Journal of Medical Imaging

基　　金：浙江省卫生计生委浙江省财政厅浙江省卫生创新人才培养资助项目(编号:2016-22)

摘　　要：目的探讨纯磨玻璃肺小腺癌(≤20mm)内异常空气支气管征与病理亚型的相关性。方法回顾性分析204例(216个结节)经手术病理证实为肺腺癌,均径在20mm以内的纯磨玻璃结节(pGGN)的影像、病理及临床资料。216个病灶中浸润前病变(PIL)130个,微浸润性腺癌(MIA)55个,浸润性腺癌(IAC)31个。将全部pGGN组(≤20mm)及亚厘米pGGN组(≤10mm)按有无异常空气支气管征各分为两组,采用2检验或Fisher精确概率法分析两组间计量资料的差异,采用独立样本t检验分析两组间计数资料的差异。结果全部216个pGGN组(≤20mm)内,有异常空气支气管病灶23个,无异常空气支气管病灶193个,两组间在病理亚型和结节均径的差异有统计学意义(P<0.05),密度差异无统计学意义(P>0.05);在150个亚厘米pGGN组(≤10mm)内,有异常空气支气管病灶8个,无异常空气支气管病灶142个,两组间在病理亚型、密度、瘤肺界面的差异无统计学意义(P>0.05),但两组的结节均径、边缘形态、胸膜凹陷征差异存在统计学意义(P<0.05)。结论pGGN肺小腺癌(≤20mm)内异常空气支气管征与病变的浸润性存在一定相关性;而亚厘米pGGN肺腺癌的浸润性则需要结合病灶大小、边缘形态等特征综合判断。Objective To discuss the correlation between abnormal air bronchograms and pathological subtypes in small lung adenocarcinoma with pure ground glass nodule(≤20 mm).Methods The images,pathological and clinical data of 204 patients(216 nodules)of pulmonary adenocarcinoma confirmed by operation and pathology were retrospectively analyzed.130 of the 216 lesions were PIL,including atypical adenomatous hyperplasia(AAH)and adenocarcinoma in situ(AIS),and 55 were minimally invasive adenocarcinoma(MIA),31 were invasive adenocarcinoma(IAC).The all pGGN group(≤20 mm)and the sub-centimeter pGGN group(≤10mm)were divided into two groups according to the presence or absence of abnormal air bronchial signs.Chi-squre and Fisher exact test were used to analyze the difference of measurement data between the two groups.Independent sample t-test was used to analyze the differences of count data between the two groups.Results Among 216 pGGN group(≤20 mm),23 cases had abnormal air bronchograms and 193 cases without abnormal air bronchograms.There were significant differences according to pathological subtypes and mean diameter between the two groups(P<0.05).There was no significant difference in density between above groups(P>0.05).In 150 sub-centimeter pGGN group(≤10 mm),8 cases had abnormal air bronchograms and 142 cases without abnormal air bronchograms.There was no significant difference according to pathological subtypes,density and tumor-lung interface between the two groups(P>0.05).And there were significant differences in nodule mean diameter,marginal morphology and pleural indentation between the two groups(P<0.05).Conclusion Abnormal air bronchograms in small pGGN lung adenocarcinoma(≤20 mm)is correlated with the invasion of the lesion,while,the invasiveness of sub-centimeter pGGN lung adenocarcinoma needs to be assessed according to the size and marginal morphology of the lesion.

关 键 词：磨玻璃结节 肺腺癌 空气支气管征 体层摄影术 X线计算机 

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