0期和Ⅰ期肺腺癌的CT形态学分型研究  

Morphological classification of pre-invasive lesions and early stage lung adenocarcinoma based on CT images

作　　者：高丰 孙英丽 金倞 肖立 张国桢 李铭 GAO Feng;SUN Yin-li;JIN Liang(Huadong Hospital Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华东医院放射科,上海200040 [2]复旦大学附属华东医院病理科,上海200040 [3]张国桢肺微小结节诊疗中心,上海200040

出　　处：《放射学实践》2024年第10期1319-1324,共6页Radiologic Practice

基　　金：上海市科委,医学创新研究专项(23Y11903400);华东医院后备导师培育计划(2023hdhbsd11)。

摘　　要：目的:回顾性分析0期和Ⅰ期肺腺癌的形态学特征并分型,探讨分型与不同病理类型间的关系。方法:通过对2106个经病理证实的0期和Ⅰ期肺腺癌的CT表现进行分析,分为10种类型,并与病理类型进行对照。运用SPSS 17.0软件进行数据分析。结果:病灶内磨玻璃成分比例与病理类型呈负相关(P=0.000,r=-0.583)。形态学分型在不同病理类型的肺腺癌中差异有统计学意义(χ^(2)=589.821,P=0.000)。在Ⅰ期浸润性肺腺癌中的不同病理亚型间,Ⅰ、Ⅱ、Ⅲ及Ⅷ型的差异有统计学意义(χ^(2)=154.462,P<0.05)。结论:不同形态学分型的肺腺癌的病理基础可能不同,形态学分型可对肺腺癌的诊断及鉴别诊断提供帮助。Objectives:To retrospectively analyze the computed tomography(CT)features in patients with pre-invasive lesions and early stage lung adenocarcinoma,and to explore the correlation between tumor morphological changes and pathological diagnoses.Methods:CT morphological characteristics in 2106 patients with pre-invasive(stage 0)and early stage(stageⅠ)lung adenocarcinoma confirmed by surgical pathology were analyzed.Based on the morphological characteristics,the lesions were divided into 10 types,as follows:typeⅠcotton ball(ground glass nodules),typeⅡfill-in solid,typeⅢgranular,typeⅣpiled-up,typeⅤpipe-wall like,typeⅥdendriform,typeⅦbubble-like lucency,typeⅧalveolate or honeycomb,typeⅨscar like,and typeⅩumbilication or perifissural.SPSS17.0 software was used for data analysis to compare morphological characteristics with pathological types.Results:Negative correlation was observed between the pathological types and proportion of ground glass component in the lesion(P=0.000 and r=-0.583).The differences of morphological classification in pre-invasive lesion and stage 0 or stageⅠlung adenocarcinomas of various pathological types were statistically significant(χ^(2)=589.821,P=0.000).Among different subtypes of stageⅠinvasive lung adenocarcinoma,there was significant difference in their manifestation of morphological typesⅠ,Ⅱ,ⅢandⅦⅠ,Ⅱ,ⅢandⅧ(χ^(2)=154.462,P<0.05).Conclusion:The 10-type morphological classification of pre-invasive lesion and stage 0 or stageⅠlung adenocarcinoma maybenefit the diagnosis and differential diagnosis of lung adenocarcinoma of various pathological types.

关 键 词：肺腺癌 形态 体层摄影术 X线计算机 

分 类 号：R730.261.1[医药卫生—肿瘤] R734.2[医药卫生—临床医学] R38R814.4