高分辨CT肺血管穿行征对肺磨玻璃结节进展的风险评估  

Risk of Progression of Ground Glass Nodule by High-Resolution CT Pulmonary Vascular Penetration Sign

作　　者：陈芳 赵红[1] 梁静静 吴宗山 CHEN Fang;ZHAO Hong;LIANG Jingjing;WU Zongshan(Department of Radiology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;不详)

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601 [2]皖西卫生职业学院附属医院影像科,安徽六安237000 [3]安徽医科大学附属六安医院影像科,安徽六安237008

出　　处：《中国医学影像学杂志》2025年第2期166-170,共5页Chinese Journal of Medical Imaging

基　　金：临床研究培育计划项目(2020LCZD12)。

摘　　要：目的 探讨肺磨玻璃结节(GGN)中伴血管穿行是否为肺结节进展的危险因素,为GGN的随访策略提供参考。资料与方法 回顾性收集2016年1月—2023年11月于皖西卫生职业学院附属医院行胸部高分辨CT并诊断为含有持续GGN(初始直径≤10 mm)患者256例。根据胸部高分辨CT图像上GGN内部是否出现肺血管穿行现象,将结节分为肺血管穿行组(A组)和无肺血管穿行组(B组)。通过评估GGN大小、密度等影像特征变化判断其进展情况,比较两组结节的无进展生存期。结果256例患者中,A组155例共196个GGN,B组101例共106个GGN,随访时间14~80个月,31个结节有进展,GGN进展率为10.3%(31/302)。两组结节随访1年无进展生存率相同,随访2~5年无进展生存率均出现平缓下降,但两组结节不同随访时间节点(36、60、80个月)的无进展生存情况差异均无统计学意义(χ^(2)=2.880,P=0.090;χ^(2)=1.683,P=0.194;χ^(2)=2.630,P=0.105)。结论 GGN中出现肺血管穿行是一种常见表现,并非结节进展的独立危险因素,不能作为判断结节恶变风险和手术干预的指标。Purpose To investigate whether concomitant vascular penetration in ground glass nodule(GGN)is a risk factor for progression of pulmonary nodule,and to inform the follow-up strategy of pulmonary GGN.Materials and Methods A retrospective collection of 256 patients who underwent high-resolution CT of the chest and were diagnosed as containing persistent GGN(initial diameter≤10 mm)at the Affiliated Hospital of West Anhui Health Vocational College from January 2016 to November 2023 was performed.The nodules were categorized into the group with pulmonary vascular penetration(group A)and the group without pulmonary vascular penetration(group B)according to whether or not pulmonary vascular penetration was present within the GGN on chest high-resolution CT images.The progression of GGN was judged by evaluating the changes in imaging features such as size and density,and the progression-free survival of the nodules between the two groups was compared.Results Among 256 patients,155 patients(196 GGN)were divided in group A and 101 patients(106 GGN)in group B.During 14 to 80 months period,31 nodules had progressed,and the rate of GGN progression was 10.3%(31/302).Nodes in both groups had the same progression-free survival rate at 1 year of follow-up,and there was a flat decline in progression-free survival rate from 2 to 5 years of follow-up,but the differences in progression-free survival between different follow-up time nodes(36,60 and 80 months)were not statistically significant in either group(χ^(2)=2.880,P=0.090;χ^(2)=1.683,P=0.194;χ^(2)=2.630,P=0.105).Conclusion The presence of pulmonary vascular penetration in pulmonary GGN is a common presentation and is not an independent risk factor for nodule progression,and cannot be used as an indicator of the risk of nodule malignancy and surgical intervention.

关 键 词：肺结节 肺肿瘤 腺癌 体层摄影术 X线计算机 风险 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]