同侧多原发性肺结节中次病灶影像学特征和病理相关性经验总结  

Summary of Experience Related to Imaging Findings and Clinical Pathology of Multiple Primary Pulmonary Nodules in The Same Side

作　　者：冷雪春 韩东 张瑞瑞 李朋玲[4] 胡忠吾[1] Leng Xue-chun;Han Dong;Zhang Rui-rui;Li Peng-ling;Hu Zhong-wu(Department of Thoracic Surgery,Huaian First Affiliated Hospital of Nanjing Medical University,Huaian 223300,Jiangsu Province,China;Imaging Department of Huaian First Hospital Affiliated to Nanjing Medical University,Huaian 223300,Jiangsu Province,China;Department of Pathology,Huaian First Affiliated Hospital of Nanjing Medical University,Huaian 223300,Jiangsu Province,China;Respiratory Department of Huaian First Affiliated Hospital of Nanjing Medical University,Huaian 223300,Jiangsu Province,China)

机构地区：[1]南京医科大学附属淮安一院胸外科,江苏淮安223300 [2]南京医科大学附属淮安一院影像科,江苏淮安223300 [3]南京医科大学附属淮安一院病理科,江苏淮安223300 [4]南京医科大学附属淮安一院呼吸科,江苏淮安223300

出　　处：《中国CT和MRI杂志》2023年第10期77-79,共3页Chinese Journal of CT and MRI

基　　金：淮安市卫生健康科研项目(HAWJ201909)。

摘　　要：目的 探讨多原发性肺结节次病灶影像学特征与临床病理的关系。方法 收集2018年1月到2022年5月在南京医科大学附属淮安一院行手术切除的10 1例多发肺结节(直径小于3cm)患者的临床资料,将次病灶分为良性组和癌及癌前病变组,统计分析其影像学特征同临床病理关系。结果 101例患者共切除肺结节241枚,主病灶病理为非典型腺瘤病变等级以上,次病灶结节共切除140枚,良性结节36例(25.71%),非典型腺瘤样增生(AAH)24例(17.14%),原位癌(AIS)25例(17.86%),微浸润腺癌(MIA)12例(8.57%),浸润性腺癌(IAC)43例(30.71%)。形态上纯磨玻璃和亚实性结节(P=0.012)、边界清晰(P=0.00)、毛刺(P=0.00)、空泡(P=0.00)等影像学特征上癌及癌前病变组高于良性组,而大小(7.72±3.60VS 7.68±3.58,P=0.875)、密度(-265±446 VS-401±227,P=0.05)、人工智能预测(P=0.365)对次病灶癌及癌前病变判断并没有统计学意义。结论 多发性肺结节次病灶结节CT影像学特征和病理特征存在一定相关性。Objective To explore the relationship between imaging features and clinical pathology of secondary lesions in patients with multiple primary pulmonary nodules.Methods The clinical data of 101 patients with multiple pulmonary nodules(less than 3cm in diameter)who were surgically resected in Huai'an First Hospital affiliated to Nanjing Medical University from January 2018 to May 2022 were collected.The secondary lesions were divided into benign group and cancer and precancerous lesions group,and the relationship between their imaging characteristics and clinical pathology was statistically analyzed.Results A total of 241 pulmonary nodules were resected in 101 patients.The pathological of the main lesion was above the grade of atypical adenoma.A total of 140 nodules were resected from secondary lesions,36 benign nodules(25.71%),24 atypical adenomatous hyperplasia(AAH)(17.14%),25 carcinoma in situ(AIS)(17.86%),12 minimally invasive adenocarcinoma(MIA)(8.57%),and 43 invasive adenocarcinoma(IAC)(30.71%).Morphologically,pure ground glass and sub solid nodules(P=0.012),clear borders(P=0.00),burrs(P=0.00),vacuoles(P=0.00)and other imaging features were higher in the cancer and precancerous lesions group than in the benign group,while the size[(7.72±3.60)vs(7.68±3.58),P=0.875],density[(-265±446)vs(-401±227),P=0.05],and artificial intelligence prediction(P=0.365)had no statistical significance in judging the cancer and precancerous lesions in the secondary lesions.Conclusion There is a certain correlation between CT imaging features and pathological features of multiple pulmonary nodules.

关 键 词：多发性肺结节 病理 CT 次病灶 影像学特点 诊断 

分 类 号：R563[医药卫生—呼吸系统]