实性孤立性肺浸润性黏液腺癌与非黏液腺癌的CT表现差异  

Differences in CT findings between solid solitary mucinous lung invasive adenocarcinoma and non-mucinous lung invasive adenocarcinoma

作　　者：吴顺 李琦[1] 何小群[1] 龚军伟 霍继文 WU Shun;LI Qi;HE Xiaoqun;GONG Junwei;HUO Jiwen(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《第三军医大学学报》2021年第19期1919-1924,共6页Journal of Third Military Medical University

摘　　要：目的探讨实性孤立性肺浸润性黏液腺癌(solid solitary mucinous lung invasive adenocarcinoma, SS-MLIA)与实性孤立性肺浸润性非黏液腺癌(solid solitary non-mucinous lung invasive adenocarcinoma, SS-NMLIA)的CT表现差异。方法回顾性分析本院2014-2020年经手术病理证实的47例SS-MLIA(黏液腺癌组)与277例SS-NMLIA(对照组)患者的临床及CT资料,比较两组临床特征及CT征象。结果 (1)临床特征:两组间性别、年龄、吸烟史及临床TNM分期差异均无统计学意义。(2)平扫CT征象:黏液腺癌组下叶分布、充气支气管征、钙化及紧贴胸膜的出现率均显著高于对照组,而胸膜牵拉征出现率显著低于对照组(P均<0.05),而两组边界情况、分叶征、毛刺征及含气腔隙的出现率差异均无统计学意义。(3)增强CT征象:黏液腺癌组血管造影征及液性无强化低密度区的出现率均显著高于对照组,而△CT动脉期及△CT静脉期均显著低于对照组(P均<0.05)。结论 SS-MLIA与SS-NMLIA的CT表现存在一定差异,下叶分布、充气支气管征、钙化、紧贴胸膜、强化程度较轻、血管造影征及液性无强化低密度区需高度警惕SS-MLIA。Objective To investigate the differential CT features between solid solitary mucinous lung invasive adenocarcinoma(SS-MLIA) and solid solitary non-mucinous lung invasive adenocarcinoma(SS-NMLIA). Methods A total of 47 patients with SS-MLIA and 277 patients with SS-NMLIA confirmed by pathology after operation in our hospital from January 2014 to December 2020 were included in this study. Their CT features and findings were retrospectively analyzed and compared between the 2 groups. Results(1) Clinical features: there were no significant differences in gender, age, smoking history, and clinical TNM stage between the 2 groups.(2) Plain CT findings: The incidences of distribution in the lower lobe of the lung, air bronchogram, calcification, and pleural attachment were more frequently seen in SS-MLIA, whereas pleural retraction was more common in SS-NMLIA(all P<0.05). However, no significant differences were observed in the boundary of tumors, lobulation, spiculation and air space between both groups.(3) Contrast-enhanced CT findings: CT angiogram and unenhanced low-density area were more common in SS-MLIA, and the △CT values of SS-MLIA in both arterial and venous phase were much lower than those of SS-NMLIA(all P<0.05). Conclusion SS-MLIA and SS-NMLIA have different CT features. Distribution in the lower lobe of the lung, air bronchogram, calcification, pleural attachment, CT angiogram, unenhanced low-density area, and slightly enhancement raise suspicion for SS-MLIA.

关 键 词：肺癌 黏液腺癌 体层摄影术 X线计算机 

分 类 号：R730.261[医药卫生—肿瘤] R734.2[医药卫生—临床医学]