不同病理级别囊腔型肺腺癌的临床及影像特征分析  

Clinical and imaging characteristics of lung cystic adenocarcinoma with different pathological grades

作　　者：郭宁 舒俊 张瑜 史广龙 张崴琪 GUO Ning;SHU Jun;ZHANG Yu;SHI Guanglong;ZHANG Weiqi(Department of Radiology,Xijing Hospital,the Air Force Military Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学西京医院放射科,陕西西安710032

出　　处：《实用放射学杂志》2023年第11期1767-1770,共4页Journal of Practical Radiology

摘　　要：目的探讨不同病理级别囊腔型肺腺癌的临床及影像特征。方法回顾性分析68例经病理证实的3种病理级别囊腔型肺腺癌的临床及影像学特点。结果68例囊腔型肺腺癌均为单发病灶,病理以浸润性腺癌为主,多见于中老年男性,多数无症状,好发于两肺外带,平均直径(2.1±1.0)cm,壁结节以磨玻璃结节多见。不同病理级别囊腔型肺腺癌在囊壁形态、囊腔形态及有无分隔均存在差异(P<0.05),恶性征象包括空气支气管征16例(23.5%)、血管穿行征65例(95.6%)、血管集束征17例(25.0%)、毛刺征30例(44.1%)、分叶征35例(51.5%)、胸膜牵拉征36例(52.9%)。研究结果发现病理级别越高,病灶表现的恶性征象越多、越明显。Mascalchi形态分型中以Ⅲ型最多见。结论不同病理级别的囊腔型肺腺癌临床表现无特异性,囊壁及囊腔的CT特征有诊断价值,恶性征象及生长方式有一定特点。掌握其影像特点可提高诊断率,有助于病变的早期定性。Objective To explore the clinical and imaging characteristics of lung cystic adenocarcinoma with different pathological grades.Methods The clinical and imaging data of 68 pathologically confirmed lung cystic adenocarcinomas with 3 different pathological grades were analyzed retrospectively.Results All 68 detected lung cystic adenocarcinomas on CT were solitary lesion.Most lung cystic adenocarcinoma occurred in medium-elderly men had no symptoms and were invasive adenocarcinomas.The mean diameter of lesion was(2.1±1.0)cm.Majority of lesions were located at the peripheral lung area and accompanied by ground glass nodule.There were significantly differences in the cystic wall,cystic cavity and separation among different pathologic adenocarcinoma grades(P<0.05).The malignant signs of lung cystic adenocarcinoma included air bronchogram in 16 cases(23.5%),vessel penetration in 65 cases(95.6%),vessel convergence sign in 17 cases(25.0%),spiculation sign in 30 cases(44.1%),lobulation sign in 35 cases(51.5%)and pleural traction in 36 cases(52.9%).The higher level of pathological grade the lesion had,the more malignant signs were seen.The most common type in cystic lung adenocarcinoma was typeⅢbased on Mascalchi morphological classification.Conclusion The cystic lung adenocarcinoma with different pathological grades haven’t clinical specificity.The morphology of the cystic wall and cystic cavity is with the diagnostic value,involving the certain characteristics of growth pattern and malignant signs.Familiarity with its characteristics can improve the accuracy of diagnosis and the early identification of lesions.

关 键 词：肺腺癌 囊腔 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]