≤2cm孤立性肺结节影像学评价及与术后病理相关性  

Imaging evaluation of ≤2cm solitary pulmonary nodule and its correlation with postoperative pathology

作　　者：虞林湘 章斌 邹浩生 施义 程亮 张颖 YU Linxiang;ZHANG Bin;ZOU Haosheng;SHI Yi;CHENG Liang;ZHANG Ying(Department of Cardiothoracic Surgery,the Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院心胸外科,江苏南京210029

出　　处：《实用放射学杂志》2023年第7期1080-1084,共5页Journal of Practical Radiology

摘　　要：目的 探讨≤ 2 cm孤立性肺结节(SPN)影像学评价及与术后病理相关性.方法 选取经病理或穿刺活检确诊的SPN患者206例.收集患者的一般临床资料、影像学检查指标、肺肿瘤标志物.统计所有患者术后病理结果.构建并评价预测≤2 cm SPN患者术后病理结果的列线图模型.使用受试者工作特征(ROC)曲线分析Cyfra21-1、磨玻璃结节(GGN)、分叶征、联合分析及列线图模型的预测效能.结果 直径≥10 mm、毛刺征、分叶征、含磨玻璃成分、血管集束征、Cyfra21-1均是SPN患者术后病理结果的影响因素(P<0.05).列线图模型的区分度和准确性均较高.Cyfra21-1+GGN+分叶征联合与列线图模型对≤2 cm SPN患者术后病理恶性的预测价值相当,且均大于各研究指标单独的预测价值.结论 构建的列线图模型以及GGN分叶征影像学结合肿瘤学指标Cyfra21-1均可较准确地判断≤2 cm SPN良恶性.Objective To investigate imaging evaluation of≤2 cm solitary pulmonary nodule(SPN)and its correlation with postoperative pathology.Methods A total of 206 patients with SPN confirmed by pathology or biopsy were selected.The general clinical data,imaging indexes and lung tumor markers were collected,and the postoperative pathological results of all cases were analyzed.Nomogram model was used to predict postoperative pathological results.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of Cyfra21-1,ground-glass nodule(GGN),lobulation sign,combined analysis and the Nomogram model.ResultsDiameter≥lo mm,spiculation sign,lobulation sign,ground glass composition,vascular convergence sign and Cyfra21-1 were the influencing factors of postoperative pathological results of SPN(P<0.05).The discrimination and accuracy of the Nomogram model were high.The predictive value of Cyfra21-1+GGN+lobulation sign was similar to that of the Nomogram model for postoperative pathological malignancy of≤2 cm SPN,and both were greater than independent predictive value of each research index alone.Conclusion The Nomogram model and the lobulation sign imaging of GGN combined with Cyfra21-1 can judge≤2 cm SPN is benign or malignant accurately.

关 键 词：磨玻璃结节 分叶征 影像学 术后病理 

分 类 号：R563[医药卫生—呼吸系统] R814.4[医药卫生—内科学] R446.8[医药卫生—临床医学]