CT特征预测无或少实性成分磨玻璃样肺腺癌浸润程度的价值  

Value of CT features in predicting invasive degree of lung adenocarcinoma shown as ground-glass nodule with no or few solid components

作　　者：胡磊[1] 朱浩雨 徐杨飞 汪志亮 刘啸峰[1] 程元骏 张虎 HU Lei;ZHU Haoyu;XU Yangfei;WANG Zhiliang;LIU Xiaofeng;CHENG Yuanjun;ZHANG Hu(Department of Medical Imaging,Chizhou People's Hospital,Chizhou,Anhui Province 247100,China;Department of Cardiothoracic Surgery,Chizhou People's Hospital,Chizhou,Anhui Province 247100,China;Department of Medical Imaging,Wuhu Second People's Hospital,Wuhu,Anhui Province 241000,China)

机构地区：[1]池州市人民医院医学影像科,安徽池州247100 [2]池州市人民医院胸心外科,安徽池州247100 [3]芜湖市第二人民医院医学影像科,安徽芜湖241000

出　　处：《实用放射学杂志》2023年第8期1236-1240,共5页Journal of Practical Radiology

基　　金：安徽省重点研究与开发计划项目(202104j07020055)。

摘　　要：目的探讨CT特征在预测无或少实性成分磨玻璃样肺腺癌浸润程度中的价值。方法回顾性选取经手术病理证实,CT表现为纯磨玻璃结节(pGGN)和肿瘤实性成分比值(CTR)≤0.25的混合磨玻璃结节(mGGN)的肺腺癌患者133例(136个病灶),根据病理结果分成微浸润腺癌(MIA)和浸润性腺癌(IAC)2组。分别记录2组病灶的临床资料和CT特征,并对其进行统计学分析。结果2组间年龄、结节直径、平均CT值、结节类型、深分叶、胸膜凹陷征、空气支气管征、空泡征、微血管CT成像征、血管集束征以及血管弯曲征的差异有统计学意义(P<0.05)。多因素分析显示结节直径、平均CT值和微血管CT成像征是预测肺腺癌浸润程度的独立危险因素,受试者工作特征(ROC)曲线分析,曲线下面积(AUC)分别为0.845、0.677和0.731,其中三者联合诊断的预测效能最高,AUC为0.898,敏感度和特异度分别为0.773、0.900。病灶直径为11.5mm、平均CT值为-412.5HU是鉴别MIA与IAC的最佳截断值。结论CT特征对鉴别无或少实性成分磨玻璃样肺腺癌的病理类型具有较高价值,结节直径、平均CT值和微血管CT成像征三者联合诊断效能优于单一特征。Objective To investigate the value of CT features in predicting the invasion degree of lung adenocarcinoma shown as ground-glass nodule with no or few solid components.Methods A total of 133 patients(136 nodules in total)with lung adenocarcinoma confirmed by postoperative pathology,and shown as pure ground-glass nodule(pGGN)or mixed ground-glass nodule(mGGN)with consolidation tumor ratio(CTR)≤<o.25 on CT were analyzed retrospectively.According to the pathological results,the patients were divided into minimally invasive adenocarcinoma(MIA)group and invasive adenocarcinoma(IAC)group,respectively.The clinical data and CT features were recorded and analyzed,and statistic analysis was made on the result.Results There were significant differences in the age,nodule diameter,mean CT value,type,deep lobulation,pleural indentation sign,air bronchogram sign,vocule sign,microvascular CT imaging sign,vessel convergence sign and vessel bending sign between the two groups(P<0.05).Multivariate analysis showed that the nodule diameter,mean CT value and microvascular CT imaging sign were independent risk factors for predicting the invasion degree of the lung adenocarcinoma,and the area under the curve(AUC)were 0.845,0.677 and 0.731,respectively.Combination of the three factors had the highest predictive power,and the AUC,sensitivity and specificity were 0.898,0.773 and 0.900,respectively.

关 键 词：磨玻璃结节 肺腺癌 计算机体层成像 

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