肺腺癌实性成分CT影像与病理特征的相关性分析  

Correlation between CT imaging and pathological features of solid components in lung adenocarcinoma

作　　者：段劲松 杨金伟 刘立陶 魏士翔 DUAN Jinsong;YANG Jinwei;LIU Litao;WEI Shixiang(Radiology Department of Langfang People's Hospital,Hebei Langfang 065000,China)

机构地区：[1]廊坊市人民医院放射诊断科,河北廊坊065000

出　　处：《现代肿瘤医学》2022年第23期4338-4343,共6页Journal of Modern Oncology

摘　　要：目的:探究肺腺癌患者胸部CT肺窗和纵隔窗中实性成分的最大径和病理浸润的相关性。方法:本研究纳入378例病理学诊断为原位腺癌、微浸润腺癌、浸润性贴壁样腺癌、浸润性腺泡样腺癌、浸润性乳头状腺癌、浸润性微小乳头状腺癌和浸润性实性腺癌的患者,4名放射科主任医师分为两组,分别在胸部CT肺窗和纵隔窗中测量结节实性成分最大径和整个结节的直径,结节实性比例由实性成分最大径(肺窗和纵隔窗)除以整个结节直径(肺窗)计算,2名病理主任医师测定浸润性腺癌的最大径。结果:结节实性比例由高到低依次为,浸润性微小乳头状腺癌、浸润性实性腺癌、浸润性腺泡样腺癌、浸润性乳头状腺癌、浸润性贴壁样腺癌、微浸润腺癌、原位腺癌。当肺窗结节实性比例>0.8或纵隔窗结节实性比例>0.6提示病理学浸润>0.5 cm。结论:肺窗结节实性比例>0.8或纵隔窗结节实性比例>0.6提示病理学浸润,并可用于鉴别原位腺癌、微浸润腺癌和浸润性腺癌。Objective:To explore the correlation between the maximum diameter of solid components in lung window and mediastinal window and pathological invasion in patients with lung adenocarcinoma.Methods:378 patients diagnosed adenocarcinoma in situ,microinvasive adenocarcinoma,invasive adherent adenocarcinoma,invasive acinar adenocarcinoma,invasive papillary adenocarcinoma,invasive micropapillary adenocarcinoma and invasive solid adenocarcinoma were included in this study.Four radiologists were divided into two groups,and the maximum diameter of solid components and the whole nodule were measured in lung window and mediastinal window of chest CT.The maximum diameter of the solid component(lung window and mediastinal window)was divided by the diameter of the whole nodule(lung window).The maximum diameter of invasive adenocarcinoma was determined by two chief pathologists.Results:The proportion of solid nodules from high to low was invasive papillary adenocarcinoma,invasive solid adenocarcinoma,invasive acinar adenocarcinoma,invasive papillary adenocarcinoma,invasive adherent adenocarcinoma,microinvasive adenocarcinoma,adenocarcinoma in situ.When the solid ratio of lung window nodules>0.8 or mediastinal window nodules>0.6,pathological infiltration>0.5 cm was indicated.Conclusion:The solid part with lung window>0.8 or the solid part with mediastinal window>0.6 can predict the pathological invasion of tissue tumor,and can be used to differentiate adenocarcinoma in situ,microinvasive adenocarcinoma and invasive adenocarcinoma.

关 键 词：浸润 腺癌 肺窗 纵隔窗 

分 类 号：R734.2[医药卫生—肿瘤]