肺结节术前薄层CT征象及定量参数与术后病理对照研究  

Comparative Study of Preoperative Thin-slice CT Signs and Quantitative Parameters of Pulmonary Nodules and Postoperative Pathology

作　　者：赵蕾[1] 马爱珍 史展[1] ZHAO Lei;MA Ai-zhen;SHI Zhan(Imaging Center,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471000

出　　处：《罕少疾病杂志》2023年第12期37-39,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨肺结节术前薄层电子计算机断层扫描(CT)征象及定量参数与术后病理组织亚型及浸润性的关系。方法收集2021年6月~2022年6月期间本院收治的2 cm以下肺结节且术后组织病理学证实为肺腺癌的119例患者的临床资料。所有患者均接受术前薄层CT检查,以术后组织病理学检查结果为依据,比较高危病理亚型与其他亚型患者薄层CT定量参数(结节长径、实性成分长径和占比,结节及其周围肺组织的CT值、GGO与周围肺组织CT比值),比较无/微浸润腺癌与浸润性腺癌患者CT征象及定量参数,并分析薄层CT定量参数对浸润性腺癌的诊断价值。结果本次共纳入119例(119枚磨玻璃结节),术后病理显示,高危病理亚型14例[含实体亚型8例、含微乳头亚型6例],其他亚型105例[附壁型13例、腺泡型79例、乳头型例10、黏液腺癌2例、未分类1例],高危病理亚型患者实性结节成分长径大于其他亚型(P<0.05)。术后病理显示,无/微浸润腺癌35例[pTis 8例、PT1mi 27例],浸润性腺癌84例[pT1a 31例、pT1b 41例、pT212例],浸润性腺癌毛刺征、血管集束征、胸膜凹陷征占比高于无/微浸润腺癌(P<0.05),浸润性腺癌结节长径、实性成分长径、实性成分占比、结节CT值、GGO与周围肺组织CT比值均大于无/微浸润腺癌(P<0.05)。绘制ROC曲线分析显示,薄层CT定量参数中结节长径(AUC=0.697)、实性成分长径(AUC=0.837)、实性成分占比(AUC=0.731)、结节CT值(AUC=0.823)、GGO与周围肺组织CT比值(AUC=0.746)对浸润性肺癌均有较好的诊断价值(P<0.05)。结论肺结节术前薄层CT征象及定量参数在不同浸润程度肺腺癌患者中存在差异,且术前结节长径、实性成分长径和占比、结节CT值、GGO与周围肺组织CT比值对病理组织浸润性有较好的诊断价值。Objective To investigate the relationship between preoperative thin-layer computed tomography(CT)signs and quantitative parameters of pulmonary nodules and postoperative histological subtypes and invasiveness.Methods The clinical data of 119 patients with pulmonary nodules less than 2 cm in our hospital from June 2021 to June 2022 who were confirmed to be lung adenocarcinoma by postoperative histopathology were collected.All patients underwent preoperative thin-slice CT examination.Based on the postoperative histopathological findings,the quantitative parameters of thin-slice CT(nodule long diameter,solid component long diameter and proportion,CT value of nodule and surrounding lung tissue,GGO and surrounding lung tissue CT ratio)of patients with high-risk pathological subtypes and other subtypes were compared,and the CT features and quantitative parameters were compared in patients with non/minimally invasive adenocarcinoma and invasive adenocarcinoma.The diagnostic value of thin-slice CT quantitative parameters for invasive adenocarcinoma was also analyzed.Results 119 cases(119 glass nodules)were included..Postoperative pathology showed that there were 14 cases of high-risk pathological subtypes(8 cases of solid subtype,6 cases of micropapillary subtype),and 105 cases of other subtypes(13 cases of mural type,79 cases of acinar type,and 10 cases of papillary type,2 cases of mucinous adenocarcinoma and 1 case of unclassified).The length and diameter of solid nodules in patients with high-risk pathological subtypes were larger than those in other subtypes(P<0.05).Postoperative pathology showed that there were 35 cases of non/minimally invasive adenocarcinoma[8 cases of pTis,27 cases of PT1mi],and 84 cases of invasive adenocarcinoma[31 cases of pT1a,41 cases of pT1b,12 cases of pT2].In invasive adenocarcinoma,the proportion of spicule sign,vascular cluster sign,and pleural depression sign was higher than that in non/minimally invasive adenocarcinoma(P<0.05).Invasive adenocarcinoma nodule length,solid component leng

关 键 词：薄层电子计算机断层扫描 定量参数 病理亚型 浸润程度 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]