肺部亚实性结节的CT随访方案探讨  

Discussion on CT Follow-up Scheme of Sub-Solid Modules

作　　者：胡容 陈昌美 曾宪春[2] 王荣品[2] 吴家红 HU Rong;CHEN Chang-mei;ZENG Xian-chun;WANG Rong-pin;WU Jia-hong(School of public health and health,Guizhou Medical University,Guiyang 550025,Guizhou Province,China;Department of medical imaging,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou Province,China;School of basic medicine,Guizhou Medical University,Guiyang 550025,Guizhou Province,China)

机构地区：[1]贵州医科大学公共卫生与健康学院,贵州贵阳550025 [2]贵州省人民医院医学影像科,贵州贵阳550002 [3]贵州医科大学基础医学院,贵州贵阳550025

出　　处：《中国CT和MRI杂志》2023年第4期44-46,61,共4页Chinese Journal of CT and MRI

基　　金：贵阳市科技计划项目(筑科合同[2020]-4-1号)。

摘　　要：目的 探讨肺部亚实性结节的CT随访方案。方法 收集本院2015年12月至2020年12月行胸部CT平扫127例,共计335个肺部亚实性结节,并随访复查CT 4-9次患者资料,根据结节类别分A组:纯GGNs(3mm<直径≤5mm)、B组:纯GGNs(直径>5mm组)、C组:PSN(3mm<直径≤8mm组)、D组:PSN(直径>8mm组),并对比各组各随访期以及各随访期内不同复查频次间结节动态变化的百分比。结果 A组纯GGNs在各随访期发生动态变化的百分比差异无统计学意义(P>0.05)。B组纯GGNs在0~3月与3~6月发生动态变化的百分比之间的差异均有统计学意义(χ^(2)=5.90,P<0.05)。与C组PSN相比,D组PSN在0~3月和3~6月随访期间发生动态变化的百分比较高,两组间的差异有统计学意义(χ^(2)=4.65,P=0.03;χ^(2)=4.05,P=0.04),且两组在不同时间段发生动态变化的百分比均有统计学意义(C组:χ^(2)=4.45,P=0.04;D组:χ^(2)=5.38,P=0.02);纯GGNs在各随访期内不同复查频次之间的差异无统计学意义(P>0.05);PSN在随访12~24月期间,复查1次和3次之间的差异具有统计学意义(χ^(2)=5.90,P<0.05)。结论 对于直径>5mm的纯磨玻璃结节人群建议在专家共识方案上增加一次3-6月随访,其余部分实性结节不同类别及大小均建议按国内专家共识随访。Objective To explore the CT follow-up plan of sub-solid nodules.Methods The data of 127 patients with 335 pulmonary sub solid nodules who underwent chest CT plain scan from December 2015 to December 2020 were collected,and the patients were followed up for 4-9 times.According to the type of nodules,they were divided into group A:pure GGNs(3mm<diameter≤5mm),group B:pure GGNs(diameter>5mm),group C:PSN(3mm<diameter≤8mm),group D:PSN(diameter>8mm).The percentage of dynamic changes of nodules in each follow-up period and different review frequencies in each follow-up period were compared.Results There was no significant difference in the percentage of dynamic changes of pure GGNs in group A during each follow-up period(P>0.05).In group B,there were significant differences in the percentage of dynamic changes of pure GGNs between 0~3 months and 3~6 months(χ^(2)=5.90,P=0.02).The percentage of dynamic changes of PSN in group D was higher than that in group C during the follow-up period of 0~3 months and 3~6 months,and there was significant difference between the two groups(χ^(2)=4.65,P=0.03;χ^(2)=4.05,P=0.04),and the percentage of dynamic changes in groups C and D in different time periods was statistically significant(group C:χ^(2)=4.45,P=0.04;group D:χ^(2)=5.38,P=0.02).There was no significant difference in the frequency of reexamination of pure GGNs during different follow-up periods(P>0.05),but there was significant difference between one and three times of PSN during the follow-up period of 12~24 months(χ^(2)=5.90,P<0.05).Conclusion Compared with the domestic experts'consensus that there is excessive follow-up examination in Guiyang sub-solid nodules,it is suggested that the pure ground glass nodules with diameter>5mm should be followed up for 3-6 months,and the other solid nodules with different types and sizes should be followed up according to the domestic expert consensus.

关 键 词：肺结节 亚实性结节 随访 肺腺癌 肺癌 

分 类 号：R730[医药卫生—肿瘤]