肺磨玻璃结节CT特征预测早期肺腺癌浸润性的价值  

The Value of CT Features of Ground-Glass Pulmonary Nodules in Predicting the Invasiveness of Early Lung Adenocarcinoma

作　　者：尹雪梅 张俊 李文菲[1] 李晓超[2] 刘德丰[1] 王良 李英杰[1] YIN Xue-mei;ZHANG Jun;LI Wen-fei;LI Xiao-chao;LIU De-feng;WANG liang;LI Ying-jie(Department of Medical Imaging,the First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Pathology,the First Hospital of Qinhuangdao,Qinhuangdao 066000,Hebei Province,China;Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]河北省秦皇岛市第一医院医学影像科,河北秦皇岛066000 [2]河北省秦皇岛市第一医院病理科,河北秦皇岛066000 [3]首都医科大学附属北京友谊医院放射科,北京100050

出　　处：《中国CT和MRI杂志》2022年第11期74-77,共4页Chinese Journal of CT and MRI

基　　金：秦皇岛市科技局计划项目(202004A089)。

摘　　要：目的通过分析肺磨玻璃结节(GGN)的CT特征,预测早期肺腺癌浸润性的价值。方法回顾性收集305例经手术病理证实的肺GGN患者的临床相关资料,根据病理类型分为浸润前GGN组104例和浸润性GGN组201例。CT特征包括定量指标(最大径及CT平均值)及肿瘤内微结构改变的相关指标(肿瘤内微血管CT成像征、空气支气管征、空泡征)。结果“肿瘤微血管CT成像征”不同分型在两组病理分类之间比较存在统计学差异(P﹤0.001)。GGN最大径预测浸润前与浸润性病变的最佳临界值为1.0cm,CT平均值预测浸润前与浸润性病变的最佳临界值为-554.7HU。空泡征、肿瘤微血管CT成像征在两组间比较均具有统计学差异(P﹤0.05),空气支气管征在两组间比较无统计学差异(P﹥0.05)。联合指标评估早期肺腺癌浸润性的诊断效能较高,其中肿瘤异常微血管CT成像征预测早期肺腺癌浸润性的价值最大。结论通过分析GGN定量指标及内微结构改变的相关影像征象,可以提高预测早期肺腺癌浸润性的诊断效能。Objective The value of predicting the invasiveness of early lung adenocarcinoma by analyzing the CT features of ground-glass lung nodules(GGN).Methods The clinical data of 305 patients with pulmonary GGN confirmed by surgery and pathology were retrospectively collected.According to the pathological type,they were divided into 104 cases in the pre-infiltration GGN group and 201 cases in the infiltrating GGN group.CT features include quantitative indicators(maximum diameter and CT average value)and related indicators of intratumoral microstructure changes(intratumor microvascular CT imaging sign,air bronchial sign,vacuole sign).Results The different types of tumor microvascular CT imaging signs were statistically different between the two groups of pathological classifications(P﹤0.001).The best critical value of GGN maximum diameter to predict pre-invasive and invasive lesions was 1.0cm,and the best critical value of CT mean to predict pre-invasive and invasive lesions was-554.7HU.The vacuole sign and tumor microvascular CT imaging sign were statistically different between the two groups(P﹤0.05),and the air bronchial sign was not statistically different between the two groups(P﹥0.05).The combined index has a high diagnostic efficiency in evaluating the invasiveness of early lung adenocarcinoma,and CT imaging signs of abnormal microvessels of the tumor have the greatest value in predicting the invasiveness of early lung adenocarcinoma.Conclusion By analyzing the GGN quantitative indicators and related imaging signs of internal microstructure changes,the diagnostic efficiency of predicting the infiltration of early lung adenocarcinoma can be improved.

关 键 词：磨玻璃结节 计算机体层摄影术 CT特征 早期肺腺癌 浸润 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]