多层螺旋CT对浸润性肺腺癌最新国际肺癌研究协会三级系统的预测价值  

Predictive value of multi-slice spiral CT for invasive lung adenocarcinoma in the latest international association for the study of lung cancer tertiary system

作　　者：吴子玉 张武[2] 朱光宇[2] 马雪梅[3] 吕仁杰[2] 田佳明 吴成贵 胡志 陆政宇 卢迪 WU Ziyu;ZHANG Wu;ZHU Guangyu;MA Xuemei;LÜRenjie;TIAN Jiaming;WU Chenggui;HU Zhi;LU Zhengyu;LU Di(School of Clinical Medicine,Jiamusi University,Jiamusi 154000,China;Department of Medical Imaging Centre,The First Affiliated Hospital of Jiamusi University,Jiamusi 154000,China;Department of Respiratory Medicine,The First Affiliated Hospital of Jiamusi University,Jiamusi 154000,China;CT Room,Jiamusi Tumor Hospital,Jiamusi 154000,China)

机构地区：[1]佳木斯大学临床医学院,黑龙江佳木斯154000 [2]佳木斯大学附属第一医院医学影像中心,黑龙江佳木斯154000 [3]佳木斯大学附属第一医院呼吸内科,黑龙江佳木斯154000 [4]佳木斯市肿瘤医院CT室,黑龙江佳木斯154000

出　　处：《分子影像学杂志》2024年第5期507-512,共6页Journal of Molecular Imaging

基　　金：佳木斯大学附属第一医院国家重点专科建设项目(GJ202302)。

摘　　要：目的探讨多层螺旋CT(MSCT)对浸润性肺腺癌新版三级分层系统的预测价值。方法回顾性收集2022年7月~2023年9月佳木斯大学附属第一医院心胸外科病区收治的120例经病理证实为浸润性肺腺癌患者的临床、MSCT及病理资料,根据最新版国际肺癌研究协会(IASLC)设定的浸润性肺腺癌三级分层系统将病例分为高分化组(贴壁型为主,且高级别成分<20%,n=17)、中分化组(腺泡型、乳头型为主,且高级别成分<20%,n=61)和低分化组(任何亚型且高级别成分≥20%,n=42)。分析比较3组患者的MSCT征象与分化程度的关系。结果单因素分析结果显示,3组间年龄、性别、吸烟史的差异无统计学意义(P>0.05);低分化组与中、高分化组的病灶大小、病灶类型、分叶征、棘突征、含气腔隙、空气支气管征、阻塞性肺气肿、血管改变和胸腔肿大淋巴结的差异有统计学意义(P<0.05),病灶数量、病灶形态、毛刺征、钙化和胸膜凹陷征的差异无统计学意义(P>0.05)。多元有序Logistic回归分析结果显示,病灶大小(OR=1.093,P=0.001)和病灶类型(OR=0.308,P=0.033)为肺腺癌最新IASLC三级分层系统中低分化的危险因素。结论MSCT对浸润性肺腺癌最新IASLC三级分层系统具有一定的预测价值,可指导临床为患者制定符合个体化的治疗方案。Objective To investigate the predictive value of multi-slice spiral CT(MSCT)for invasive lung adenocarcinoma with the new version of the three-stage stratification system.Methods The clinical,MSCT and pathological data of 120 patients with pathologically confirmed invasive lung adenocarcinoma admitted to the Cardiothoracic Surgical Ward of the First Affiliated Hospital of Jiamusi University from July 2022 to September 2023 were retrospectively collected,and the cases were classified into the highly differentiated group(predominantly adherent type,and the high-grade component<20%,n=17),the moderately differentiated group(predominantly acinar/nipple type,and the high-grade component<20%,n=61),and the low differentiated group(any subtype and high-grade component≥20%,n=42).The relationship between MSCT signs and the degree of differentiation in the three groups was analyzed and compared among the three groups of patients.Results The results of univariate analysis showed that there was no statistically significant difference in age,gender and smoking history among the three groups(P>0.05).The differences in diameter,lesion type,lobulated sign,spinous process sign,air-containing cavities,air bronchogram sign,obstructive emphysema,changes of vessels,and lymphadenectasis between the low differentiated group and the moderately-and highly differentiated groups were statistically significant(P<0.05),and the differences in the number and shape of the lesions,and the spicule sign,calcification and pleural traction sign were not statistically significant(P>0.05).The results of multivariate ordered Logistic regression analysis showed that diameter(OR=1.093,P=0.001)and lesion type(OR=0.308,P=0.033)were risk factors for low-differentiated in the latest IASLC tertiary stratification system for lung adenocarcinoma.Conclusion MSCT has a predictive value for the latest IASLC tertiary stratification system of invasive lung adenocarcinoma,which can guide the clinic to formulate a treatment plan for patients in line with individualiza

关 键 词：肺肿瘤 体层摄影技术 浸润性肺腺癌 组织学分级 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]