胸膜凹陷征预测结节型肺癌脏层胸膜侵犯价值  

The value of pleural indentation in predicting visceral pleural invasion of lung cancer manifesting as nodules

作　　者：郭炜 王晓华[1] 袁慧书[1] GUO Wei;WANG Xiaohua;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院放射科,北京100191

出　　处：《实用放射学杂志》2023年第11期1764-1766,共3页Journal of Practical Radiology

摘　　要：目的评价胸膜凹陷征(PI)预测结节型肺癌脏层胸膜侵犯(VPI)的价值。方法回顾性分析经手术病理证实的98例结节型肺癌,胸部CT影像显示PI。根据第8版肺癌TNM分期标准,分为VPI组(44例)和非VPI组(54例)。分析不同类型PI诊断VPI的准确性、敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和阳性似然比(LR)。结果98例伴PI的结节型肺癌中,44例(44/98,44.9%)有VPI,54例(54/98,55.1%)无VPI。1型、2型和3型PI诊断VPI的阳性LR值分别为0.32、5.42和1.23,2型PI诊断VPI的可靠性最高。2型PI诊断VPI的敏感度、特异度、准确度、PPV、NPV分别为45.7%、91.8%、75.0%、78.5%、68.7%。结论结节型肺癌的PI尤其2型对预测VPI有一定价值,可以提高早期诊断结节型肺癌VPI的准确性,为临床术前评估提供重要信息。Objective To evaluate the value of pleural indentation(PI)in predicting visceral pleural invasion(VPI)of lung cancer with nodules.Methods A retrospective analysis of 98 patients with subsolid nodular lung cancer confirmed by surgery and pathology was performed.Chest CT images showed PI.Patients were divided into VPI group(44 patients)and non VPI group(54 patients)according to the eight edition TNM staging criteria of lung cancer.The accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and positive likelihood ratio(LR)of different types of PI were analyzed.Results Among the 98 patients with PI,44(44/98,44.9%)had VPI and 54(54/98,55.1%)had no VPI.The positive LR of type 1,type 2 and type 3 of PI in the diagnosis of VPI were 0.32,5.42 and 1.23,respectively.The presence of type 2 PI was most correlated with VPI,while the sensitivity,specificity,accuracy,PPV and NPV were 45.7%,91.8%,75.0%,78.5%and 68.7%,respectively.Conclusion The PI of lung cancer manifesting as nodules,especially type 2,can improve the accuracy of early diagnosis of VPI,and provide important information for clinical preoperative evaluation.

关 键 词：肺癌 胸膜凹陷征 脏层胸膜侵犯 

分 类 号：R734.2[医药卫生—肿瘤] R561[医药卫生—临床医学]