多层螺旋CT影像学表现与周围型肺腺癌病理组织分化及亚型关系研究  

The relationship between the multi-slice spiral CT image findings and the pathological tissue differentiation and subtypes of peripheral lung adenocarcinoma

作　　者：罗强 邓红梅[1] 罗新民 余港正 赵亚琴[2] 王慧茹 彭军 LUO Qiang;DENG Hong-mei;LUO Xin-min;YU Gang-zheng;ZHAO Ya-qin;WANG Hui-ru;PENG Jun(Department of Radiology,Yuechi County People's Hospital,Yuechi 638300,China;Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川省岳池县人民医院放射科,四川岳池638300 [2]四川大学华西医院放射科,四川成都610041

出　　处：《实用医院临床杂志》2021年第5期21-25,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技厅科研基金资助项目(编号:20180214232)。

摘　　要：目的分析周围型肺腺癌的CT影像学表现,并探讨其CT征象与病理组织分化及亚型之间的关系。方法回顾性分析2018年3月至2020年6月岳池县人民医院收治的95例周围型肺腺癌患者的临床资料,观察病灶位置、大小、形态、肿瘤边缘(分叶征、毛刺征)及内部征象(空气支气管征、空泡征)等特点。结果95例患者中浸润性肺腺癌70例,其中附壁型12例、腺泡型39例、乳头型10例、实体型9例;非浸润性25例;低分化40例,中高分化55例。4种病理亚型肺腺癌患者中,以实体型直径最长,其他类型从长到短依次为乳头型、腺泡型、附壁型(P<0.05);腺泡型、实体型分叶征显著高于附壁型、乳头型;腺泡型空气支气管征显著高于附壁型、乳头型及实体型(P<0.05),而空泡征、毛刺征、胸膜凹陷征及血管集束征比较差异无统计学意义(P>0.05)。不同组织分化程度中低分化周围型肺腺癌肿瘤直径多>3 cm,呈不规则形,CT扫描以分叶征、毛刺征及胸膜凹陷征多见,中高分化周围型肺腺癌则相反,两者上述CT征象比较差异有统计学意义(P<0.05),而空泡征、血管集束征及空气支气管征比较差异无统计学意义(P>0.05)。结论不同组织分化程度、病理亚型周围型肺腺癌的MSCT征象具有一定特征性,对周围型肺腺癌病理亚型、组织分化程度的预测有一定帮助。Objective To investigate the multi-slice spiralCT(MSCT)image findings of peripheral lung adenocarcinoma,and toexplore the relationships between the CT signs and the differentiation and subtypes of pathological tissues.Methods Clinical data of 95 patients with peripheral lung adenocarcinoma admitted to our hospital from March 2018 to June 2020 were retrospectively analyzed.The location,size,shape,tumor edge(lobular sign and/or burr sign)and internal signs(air bronchialsignand/or vacuole sign)as well as other features of the lesion were observed.Results Among the 95 patients,70 patients were infiltrating lung adenocarcinomas(12 of wall-attachment type,39 of acinar type,10 of papillary type and 9 of solid type,)and 25 patients were non-infiltrating lung adenocarcinomas.Further,there were 40 patients with low differentiation and 55 with moderate or high differentiation.Among the four pathological subtypes of lung adenocarcinoma,the solid type had the longest diameter,and the other types were papillary type,acinar type,and wall-attachment type from long to short in sequence(P<0.05).The lobular sign of the acinar type and the solid type was significantly higher than that of the wall-attachment type and the papillary type.The air-bronchial sign of the acinar type was significantly higher than that of the wall-attachment type,papillary type,and solid type(P<0.05).However,there were no statistically significant differences in the vacuole sign,burr sign,pleural indentation sign,and vascular cluster sign(P>0.05).Among different tissue differentiation,the tumor diameter of patients with peripheral lung adenocarcinomas and low differentiation was mostly>3 cm and the shape was irregular.CT scans often showed lobular sign,burr sign,and pleural indentation sign,while the peripheral lung adenocarcinomas with moderate or high differentiation were opposite(P<0.05).There were no significant differences in the vacuole sign、vascular cluster sign and air bronchial sign(P>0.05).Conclusion Peripheral lung adenocarcinoma has MSCT imagin

关 键 词：周围型肺腺癌 病理组织分化 病理亚型 多层螺旋CT 

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