原发性大气道黏液表皮样癌CT表现与病理对照  

Comparative study of CT manifestations and pathological grades of primary mucoepidermoid carcinoma of the large airway

作　　者：莫森林 胡海菁 倪志文 黄绥丹 蒙虹伽 陈淮[2] MO Sen-lin;HU Hai-jing;NI Zhi-wen(Department of Radiology,Affiliated Nanhai Hospital of Southern Medical University,Foshan 528200,China)

机构地区：[1]南方医科大学附属南海医院放射科,广东528200 [2]广州医科大学附属第一医院放射科,广州510120

出　　处：《放射学实践》2021年第6期733-737,共5页Radiologic Practice

基　　金：广东省自然科学基金项目(2019A1515011382);佛山市卫生健康局医学科研课题项目(20200381);佛山市“十三五”医学特色专科建设项目(FSTSZK011)。

摘　　要：目的:探讨原发性大气道黏液表皮样癌(MEC)CT表现与病理组织分化程度关系,提高对该病诊断水平并指导临床诊疗。方法:回顾性搜集33例经病理证实为大气道MEC患者资料,分析其CT表现并据病理组织分化程度分低级别组、高级别组进行统计学分析。结果:原发性大气道MEC均表现为中度-明显强化且低级别组强化差值较高级别组更高(P=0.012),行ROC曲线分析示两者最佳截断值44.0HU,曲线下面积(AUC)0.815,敏感度77.3%,特异度87.5%;而两者在病灶发生数量、部位、最大长径、病灶长轴与气道长轴平行、边界、密度、钙化、生长方式、肺门纵隔淋巴结肿大、阻塞性肺气肿、阻塞性肺炎、阻塞性肺不张、肺泡积血、阻塞以远支气管扩张伴黏液栓潴留、纵隔移位、胸腔积液、远处转移等方面差异无统计学意义(P=0.068~1.000)。结论:当发现年轻患者大气道腔内结节或肿块、阻塞以远支气管扩张伴黏液栓潴留、增强扫描呈中度-明显强化时应想到MEC可能;其强化差值>44.0HU时该MEC病理级别可能较低,反之,该病理级别可能较高。Objective:To analyze the CT manifestations of primary mucoepidermoid carcinoma(MEC)of large airway,and to explore the correlation between CT findings and pathological grades,so as to improve the diagnostic level and guide clinical work.Methods:The data of 33 patients with MEC of large airway confirmed by pathology were collected retrospectively,and their lung CT images were analyzed.According to the pathological grades,patients were divided into low-grade group and high-grade group for statistical analysis.Results:All primary MEC of large airway were observed moderate to obvious enhancement,while the increase of CT value in low-grade group was higer than that in high-grade group(P=0.012).ROC curve showed that the cut off value was 44.0HU,the area under the curve was 0.815,the sensitivity was 77.3%,and the specificity was 87.5%.There was no significant difference in number,location,maximum long diameter,long axis parallel to airway long axis,boundary,density,calcification,growth pattern,hilar mediastinal lymph node enlargement,obstructive emphysema,obstructive pneumonia,obstructive atelectasis,alveolar hemorrhage,distal bronchiectasis with mucus thrombus retention,mediastinal displacement,pleural effusion,distant metastasis and so on(P=0.068~1.000).Conclusion:When a moderately or obviously enhanced nodule or mass in the large airway is found in young patients,with bronchiectasis and intraluminal mucus plug,the possibility of MEC should be considered.When the increase of CT value is higher than 44HU,the pathological grade of the lesion might be lower,otherwise,the pathological grade might be higher.

关 键 词：气管肿瘤 支气管肿瘤 癌 黏液表皮样 病理 体层摄影术 X线计算机 

分 类 号：R734.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]