浸润性肺腺癌高分辨率CT特点与临床病理及预后的关系  

Relationship of high resolution CT characteristics with clinicopathology and prognosis of invasive lung adenocarcinoma

作　　者：余辉兴 胡静 赵宗盛 YU Huixing;HU Jing;ZHAO Zongsheng(The Second People's Hospital of Jingdezhen,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇市第二人民医院,江西景德镇333000

出　　处：《当代医学》2024年第10期88-93,共6页Contemporary Medicine

摘　　要：目的探究浸润性肺腺癌高分辨率CT(HRCT)特点与临床病理及预后的关系。方法选取2019年1月至2022年3月景德镇市第二人民医院肿瘤科收治的90例经手术病理证实为浸润性肺腺癌的患者作为研究对象,收集患者的临床资料与HRCT图像,比较不同腺癌亚型、不同预后患者临床病理及HRCT图像特征,采用单因素及多因素Logistic回归分析浸润性肺腺癌预后的影响因素。结果附壁型、腺泡型、乳头型肺腺癌患者病灶最大径、淋巴结转移、远处转移比较差异有统计学意义(P<0.05);附壁型、腺泡型、乳头型肺腺癌患者病灶HRCT图像基本形态、边缘征象、瘤肺边界、邻近结构、内部结构比较差异有统计学意义(P<0.05);90例患者中术后出现转移或复发19例,临床病理特征:转移或复发与未转移或复发患者性别、吸烟史、病灶最大径、伴有症状及淋巴结转移比较差异有统计学意义(P<0.05);HRCT图像特征:术后转移或复发患者HRCT图像分叶征、毛刺征阳性率均高于未转移或复发患者(P<0.05);多因素Logistic回归分析结果显示,吸烟史、淋巴结转移、分叶征、毛刺征是患者预后的危险因素(P<0.05)。结论浸润性肺腺癌不同腺癌亚型、不同预后具有不同的临床病理特征与HRCT影像学特征,吸烟史、淋巴结转移、病灶HRCT分叶征、毛刺征是浸润性腺癌患者预后的危险因素,HSCT影像学特征对评估浸润性肺腺癌患者预后有一定的价值。Objective To investigate the relationship of high resolution CT(HRCT)characteristics with clinicopathology and prognosis of invasive lung adenocarcinoma.Methods 90 patients with invasive lung adenocarcinoma confirmed by surgical pathology in department of Oncology of the Second People’s Hospital of Jingdezhen from January 2019 to March 2022 were selected as the research subjects,the clinical data and HRCT images of the patients were collected.The clinicopathological characteristics and HRCT image characteristics were compared among patients with different adenocarcinoma subtypes and different prognosis status,univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of prognosis of invasive lung adenocarcinoma.Results There were significant differences in the maximum diameter of tumor,lymph node metastasis and distant metastasis among patients with mural,acinar and papillary adenocarcinoma(P<0.05).There were statistically significant differences in the basic morphology,edge signs,tumor-lung boundary,adjacent structure and internal structure of HRCT images of lesions in patients with mural,acinar and papillary adenocarcinoma(P<0.05).There were 19 patients with postoperative metastasis or recurrence among the 90 patients,the clinicopathological characteristics revealed that the gender,smoking history,maximum lesion diameter,symptoms and lymph node metastasis revealed statistical differences between patients with metastasis or recurrence and those without metastasis or recurrence(P<0.05).HRCT image characteristics manifested that the positive rates of lobulation sign and spiculation sign in HRCT images of patients with postoperative metasta-sis or recurrence were higher than those of patients without metastasis or recurrence(P<0.05).Multivariate Logistic regression analysis showed that smoking history,lymph node metastasis,lobulation sign and spiculation sign were risk factors for prognosis(P<0.05).Conclusion Different subtypes of adenocarcinoma and different prognosis s

关 键 词：高分辨率CT 浸润性肺腺癌 影像特征 肿瘤预后评估 

分 类 号：R734.2[医药卫生—肿瘤]