平均CT值与肿瘤微血管CT成像征预测早期浸润性肺腺癌的价值  

The Diagnostic Value of Mean CT Values and Tumor Microvascular CT Signs in Predicting Early Invasive Lung Adenocarcinoma

作　　者：张俊 尹雪梅 李文菲[1] 李晓超[2] 李英杰[1] 刘德丰[1] ZHANG Jun;YIN Xuemei;LI Wenfei;LI Xiaochao;LI Yingjie;LIU Defeng(Department of Medical Imaging,The First Hospital of Qinhuangdao of Hebei Province,Qinhuangdao 066000,China;Department of Pathology,The First Hospital of Qinhuangdao of Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院医学影像科,秦皇岛066000 [2]河北省秦皇岛市第一医院病理科,秦皇岛066000

出　　处：《宁夏医科大学学报》2022年第12期1209-1213,共5页Journal of Ningxia Medical University

基　　金：秦皇岛市科技计划项目(202004A089)。

摘　　要：目的 探讨平均CT值、肿瘤微血管CT成像征及两者联合预测磨玻璃结节早期浸润性肺腺癌的价值。方法 回顾性收集秦皇岛市第一医院167例经手术病理证实的肺磨玻璃结节(GGN),根据病理类型分为浸润前病变组(不典型瘤样增生-原位腺癌)65例和浸润性病变组(微浸润腺癌-浸润性腺癌)102例。利用卡方检验及Mann-Whitney U检验比较两组肿瘤微血管CT成像征及平均CT值是否存在差异,通过Logistic回归生成两种分析指标联合诊断的预测概率,分别绘制受试者工作特征(ROC)曲线,通过最大约登指数确定平均CT值最佳临界值及平均CT值、肿瘤微血管CT成像征及联合指标的最佳诊断效能参数。结果 肿瘤微血管CT成像征及平均CT值在两组不同病理分类中比较差异有统计学意义(P<0.001)。肿瘤微血管CT成像征、平均CT值单项分析指标的诊断效能参数均较高,同时联合指标诊断效能参数中的特异度、约登指数、阳性预测值及曲线下面积(AUC)均高于单项指标;平均CT值的最佳临界值为-519 HU。结论 平均CT值、肿瘤微血管CT成像征预测GGN早期浸润性肺腺癌均有较高的诊断价值,两者的联合诊断效能高于单项指标。Objective To explore the diagnostic value of mean CT value,tumor microvascular CT imaging signs and the combination of the two in predicting the ground-glass nodules early invasive lung adenocarcinoma.Methods A retrospective collection of 167 cases of ground glass nodules(GGN)confirmed by surgery and pathology from the First Hospital of Qinhuangdao. According to the pathological types,they were divided into pre-invasive GGN group 65 cases(atypical tumor-like hyperplasia-adenocarcinoma in situ)and invasive GGN group 102 cases(micro-invasive adenocarcinoma-invasive adenocarcinoma). The chi-square test and Mann-Whitney U test were used to compare the two groups of tumor microvascular CT imaging signs and mean CT values for differences. Logistic regression was used to generate the predicted probabilities of the combined diagnosis of the two analytical indicators,and then receiver operating characteristic curves(ROC)were drawn separately,and the best cut-off value of the mean CT value and the mean CT value,CT imaging signs of tumor microvascular,and the best diagnostic performance parameters of the combined index was determined by the maximum Youden index. Results Tumor microvascular CT imaging signs and mean CT values were statistically different between the two groups of different pathological classifications(P<0.001). Tumor microvascular CT imaging signs and mean CT value of the single analysis index had higher diagnostic efficiency parameters,and the combined index diagnostic efficiency parameters of specificity,Youden index,postivepredictive value and AUC were all higher than the single index. The best critical value of average CT value was -519 HU.Conclusion The mean CT value and tumor microvascular CT imaging signs have high diagnostic value in predicting early invasive lung adenocarcinoma,and the combined comprehensive diagnostic efficiency of the two is higher than the single index.

关 键 词：肺磨玻璃结节 CT 平均CT值 肿瘤微血管CT成像征 诊断 浸润 

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