高分辨率CT在肺原位腺癌及微浸润腺癌鉴别诊断中的价值分析  

Value of High-resolution CT in the Differential Diagnosis of Lung Adenocarcinoma in Situ and Minimally Invasive Adenocarcinoma

作　　者：陈妙勤 Chen Miaoqin(Department of Radiology,The Second Affiliated Hospital of Xiamen Medical College,Xiamen,Fujian 361021)

机构地区：[1]厦门医学院附属第二医院放射影像科,福建厦门361021

出　　处：《现代医用影像学》2024年第4期648-651,共4页Modern Medical Imageology

摘　　要：目的:分析高分辨率CT(HRCT)在表现为磨玻璃结节的肺原位腺癌(AIS)及微浸润腺癌(MIA)鉴别诊断中的价值。方法:回顾性选取本院2018年3月—2023年3月期间收治的200例肺腺癌患者的临床资料为研究对象,以手术病理学诊断作为分类依据,分别设为纯磨玻璃结节组、混合磨玻璃结节组,对比两组AIS与MIA的HRCT影像学特征,并以工作特征曲线(ROC)分析影像学特征对AIS、MIA的鉴别诊断价值。结果:纯磨玻璃结节组AIS、MIA结节直径、磨玻璃成分CT值比较存在明显差异(P<0.05);混合磨玻璃结节组AIS、MIA分叶征、胸膜凹陷征、空气支气管征例数及结节直径、磨玻璃成分CT值比较存在明显差异(P<0.05);ROC曲线分析结果显示,纯磨玻璃结节组结节直径、磨玻璃成分CT值鉴别AIS、MIA曲线下面积分别为0.642、0.761,混合磨玻璃结节组分叶征、胸膜凹陷征、空气支气管征者占比,结节直径、磨玻璃成分CT值鉴别AIS、MIA曲线下面积分别为0.680、0.670、0.767、0.684、0.974。结论:HRCT能够为表现为纯磨玻璃结节及混杂密度磨玻璃结节的AIS与MIA的临床鉴别诊断提供有效信息。Objective:To analyze the value of high-resolution CT(HRCT)in the differential diagnosis of lung adenocarcinoma in situ(AIS)and minimally invasive adenocarcinoma(MIA).Methods:The clinical data of 200 patients with lung adenocarcinoma who were admitted to the hospital from March 2018 to March 2023 were analyzed retrospectively.Based on surgical and pathological results,patients enrolled were divided into the pure ground-glass nodule group and the mixed ground-glass nodule group.HRCT features of AIS and MIA in the two groups were comparatively analyzed.The diagnostic value of imaging features for AIS and MIA was analyzed using the receiver operating characteristic(ROC)curve.Results:The nodule diameters and CT values of ground-glass components in AIS and MIA were significantly different in the pure ground-glass nodule group(P<0.05).There were significant differences in the proportions of patients with lobulation sign,pleural indentation sign and air bronchogram sign,nodule diameters and CT values of ground-glass components in AIS and MIA were significantly different in the mixed ground-glass nodule group(P<0.05).ROC curve analysis results showed that for pure ground-glass nodules,the area under the curve values of nodule diameter,and CT value of ground-glass component for differential diagnosis of AIS and MIA were 0.642 and 0.761.For mixed ground glass nodules,the area under the curve values of the proportions of patients with lobulation sign,pleural indentation sign and air bronchogram sign,nodule diameter,and CT value of ground-glass component for differential diagnosis of AIS and MIA were 0.680,0.670,0.767,0.684,and 0.974,respectively.Conclusion:HRCT can provide effective information for clinical differential diagnosis of AIS and MIA that manifest as pure ground glass nodules and mixed ground-glass nodules.

关 键 词：高分辨率CT 混杂密度磨玻璃结节 肺原位腺癌 微浸润腺癌 鉴别诊断 

分 类 号：R73[医药卫生—肿瘤]