原发性肺黏液腺癌CT表现与临床病理因素相关性分析  

Correlation analysis of CT findings and clinicopathological factors in primary pulmonary mucinous adenocarcinoma

作　　者：解丙坤[1] 史忠瑞 潘泉[1] 李洪雷[3] 郑清水[1] 乔国庆[1] XIE Bing-kun;SHI Zhong-rui;PAN Quan;LI Hong-lei;ZHENG Qing-shui;QIAO Guo-qing(Dezhou People's Hospital,Dezhou 253000,P.R.China)

机构地区：[1]德州市人民医院影像科,山东德州253000 [2]德州市人民医院外科,山东德州253000 [3]德州市人民医院病理科,山东德州253000

出　　处：《中华肿瘤防治杂志》2020年第17期1393-1398,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的原发性黏液腺癌(primary pulmonary mucinous adenocarcinoma,PPMA)是一组产生黏液素的肺腺癌亚型,相对少见,低度恶性。本研究基于PPMA的CT表现,探讨其临床病理特征,旨在提高对该病的认识。方法回顾性分析2012-01-21-2019-07-08德州市人民医院经病理活检或手术确诊的40例PPMA患者完整资料,基于病变CT表现,将PPMA分为肺炎型和结节肿块型,并归纳总结相应患者的临床及病理特征。结果肺炎型占60.0%(24/40),结节肿块型占40.0%(16/40),2组在病灶分布范围(χ^2=15.859,P<0.001)、边缘磨玻璃征(χ^2=16.000,P<0.001)、支气管充气征(χ^2=19.461,P<0.001)和血管造影征(χ^2=14.158,P<0.001)等CT征象之间,差异均有统计学意义。2组在囊泡征(χ^2=0.819,P=0.366)、胸膜(χ^2=2.536,P=0.111)及淋巴结改变(χ^2=0.006,P=0.938)之间,差异无统计学意义。肺炎型具有临床症状的患者占87.5%(21/24),高于结节肿块型的23.1%(3/13),差异有统计学意义,χ^2=12.660,P<0.001。肺炎型黏液腺癌病理以浸润性黏液腺癌多见,而结节肿块型黏液腺癌病理以混合性黏液腺癌为主,差异有统计学意义,χ^2=13.352,P<0.001。2组免疫组织化学TTF-1(χ^2=2.934,P=0.087)、CK7(χ^2=0.000,P=1.000)和CK20(χ^2=1.381,P=0.240)染色阳性表达组间比较,差异无统计学意义。结论基于病变形态学CT表现,将PPMA分为肺炎型和结节肿块型,2种类型的CT表现与病理、临床密切相关,并具有一定的特异性。OBJECTIVE Primary pulmonary mucinous adenocarcinoma(PPMA)is subtype of lung adenocarcinoma producing mucin,which is relatively rare and low-grade malignant.Based on the CT findings of PPMA,this study explored its clinical and pathological characteristics,aiming to improve the understanding of this disease.METHODS From January 21,2019 to July 8,2019,40 patients diagnosed as PPMA through pathological examination by surgery or needle biopsy in Dezhou Hospital were collected.Based on the CT findings of the lesion,PPMA was divided into pneumonic type and nodular mass type,and the clinical and pathological characteristics of the corresponding patients were summarized.RESULTS Pneumonia type accounted for 60.0%(24/40),nodule and mass type accounted for 40.0%(16/40).There were statistically significant differences between the two groups of CT signs in the distribution range of lesions,edge glass sign,air bronchogram sign,angiography sign and so on(χ^2 values were 15.859,16.000,19.461 and 14.158,all P<0.001).There was no statistically significant difference between the two groups in the changes of cystic signs,pleura and lymph nodes(χ^2 values were 0.819,2.536 and 0.006,all P>0.05).There was no statistically significant difference in age,gender and other general data between the two groups(t=0.847,P=0.402;χ^2=5.434,P>0.001).The number of patients with clinical symptoms of pneumonia type was 87.5%(21/24),higher than that of nodular mass type[23.1%(3/13)],the difference was statistically significant(χ^2=12.660,P<0.001).The pathology of pneumogenic mucinous adenocarcinoma was mainly invasive mucinous adenocarcinoma,while the pathology of nodular and mass mucinous adenocarcinoma was mainly mixed mucinous adenocarcinoma,the difference between the two groups was statistically significant(χ^2=13.352,P<0.001).There was no statistically significant difference between the two groups in immunohistochemical TTF-1,CK7 and CK20 staining(χ^2 values were 2.934,0.000 and 1.381,all P>0.05).CONCLUSIONS Based on CT findings of the lesio

关 键 词：肺原发性黏液腺癌 计算机断层摄影 临床及病理特征 免疫组织化学 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]