周围型肺小鳞癌支气管改变的CT征象与病理对照  

A controlled study of imaging and pathology of bronchial changes in small squamous carcinoma of the peripheral lung

作　　者：王慧莹 陈殿森[2] 强军[2] 武聪聪 王蓓蕾 WANG Huiying;CHEN Diansen;QIANG Jun;WU Congcong;WANG Beilei(College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China;Department of Radiology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院,河南洛阳471003 [2]河南科技大学临床医学院、河南科技大学第一附属医院影像中心,河南洛阳471003

出　　处：《医学影像学杂志》2023年第2期249-252,共4页Journal of Medical Imaging

基　　金：吴阶平医学基金会临床科研专项资助基金项目(编号:320.6750.2020-08-13)。

摘　　要：目的 探讨周围型肺小鳞癌支气管改变的CT征象与病理特征。方法 选取我院经病理证实的39例周围型肺小鳞癌患者,共计42个病灶,重点对病灶内支气管改变的影像与病理特征进行对照分析。根据病灶是否伴有囊腔形成分为非囊腔鳞癌组和囊腔鳞癌组,采用Fisher确切概率法对两组的CT征象进行分析,并选取经手术及活检病理证实的病灶进行病理切片与CT图像对比,分析其影像表现的病理基础。结果 42个周围型肺鳞癌病灶,25个病灶长轴与支气管长轴一致,39个支气管在边缘截断,2个出现支气管气象,18个支气管截断前增厚,9个截断前狭窄,7个出现远端阻塞改变。非囊腔鳞癌组35个,囊腔鳞癌组7个。经统计分析可知病灶支气管在边缘截断、支气管在肿瘤内部截断在两组之间的差异有统计学意义(P<0.05),病灶的形状、毛刺征、棘突征、血管集束征、支气管截断前增厚、长轴与支气管长轴一致在两组之间差异无统计学意义(P>0.05)。结论 周围型肺小鳞癌多表现为与支气管长轴一致的类椭圆形结节,病灶内支气管截断,截断前支气管常增厚,囊腔鳞癌较非囊腔鳞癌更易出现支气管气象。Objective To investigate the imaging and pathological features of bronchial changes in small peripheral lung squamous cell carcinoma. Methods A total of 42 lesions were collected from the imaging and pathological data of 39 patients with small peripheral squamous cell carcinoma of the lung confirmed by pathology in the First Affiliated Hospital of Henan University of Science and Technology from September 2013 to February 2022. The focus was on the comparative analysis of the imaging and pathological characteristics of the bronchial changes. The lesions were divided into non-thin-walled cystic squamous cell carcinoma group and thin-walled cystic squamous cell carcinoma according to whether they were accompanied by cyst formation. Fisher’s exact probability method was used to analyze the CT signs of the two groups, and nine lesions confirmed by surgery were selected for pathological sections and compared with CT images to analyze the pathological basis of image. Results Of the 42 peripheral lung squamous cell carcinoma lesions, 25 cases had the long axis of the lesions consistent with the long axis of the bronchi, 39 cases had bronchial truncation at the edge, 2 cases had bronchial meteorology, 18 cases had thickening before bronchial truncation, cases had pre-truncation stenosis, and 7 cases had distal obstruction changes. There were 35 cases(83.33%) in the non-thin-walled cystic squamous cell carcinoma group and 7 cases(16.67%) in the thin-walled cystic squamous cell carcinoma group. Statistical analysis showed that the lesion bronchial truncation at the edge and the bronchial truncation inside the tumor were statistically significant(P<0.05), and the shape of the lesion, burrs, spikes, vascular bundles, pre-bronchial thickening, and the consistency of the major axis and bronchial long axis were not statistically significant between the two groups(P>0.05). Conclusion Small peripheral lung squamous cell carcinoma usually presents as oval nodules consistent with the long axis of the bronchus. The bronchus in the

关 键 词：周围型肺鳞癌 支气管 病理学 囊腔鳞癌 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]