Ⅰ期浸润性非黏液性肺腺癌的CT特征与病理亚型的相关性研究  

Correlations between CT characteristics and pathological subtypes of stageⅠinvasive non-mucinous lung adenocarcinoma

作　　者：王倩[1] 王蓉[1] 解丙坤 WANG Qian;WANG Rong;XIE Bingkun(Department of Radiology,Dezhou Hospital of Qilu Hospital of Shandong University,Dezhou 253000,China)

机构地区：[1]山东大学齐鲁医院德州医院放射科,山东德州253000

出　　处：《中国中西医结合影像学杂志》2025年第2期223-227,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：山东省医药卫生科技发展计划项目(202209011090)。

摘　　要：目的:探讨Ⅰ期浸润性非黏液性肺腺癌的CT特征与病理亚型的相关性,为临床决策提供帮助。方法:回顾性分析经手术病理证实的143例Ⅰ期浸润性非黏液性肺腺癌患者的临床和CT资料,其中低危组46例、中危组67例和高危组30例。采用单因素分析对3组的临床资料及CT特征进行比较,对差异有统计学意义的指标行多因素分析,绘制ROC曲线评价CT特征对病理亚型的诊断效能。结果:3组间病灶密度、肺血管异常、肿瘤实性占比(CTR)、平扫CT值比较,差异均有统计意义(均P<0.001);3组间病灶大小、分叶征、毛刺征、空泡征、支气管异常及胸膜牵拉征比较,差异均无统计学意义(均P>0.05)。多因素logistic回归分析显示,平扫CT值是鉴别低危组和中危组(P=0.004)、低危组和高危组(P=0.001)的独立危险因素;相对低危组,高危组更易出现肺血管异常,且是高危病理亚型的独立危险因素(P=0.009)。ROC曲线分析表明,平扫CT值在不同病理亚型鉴别中诊断效能较高。结论:CT特征对鉴别Ⅰ期浸润性非黏液性肺腺癌的病理亚型具有重要价值,可为临床诊疗提供参考。Objective:To investigate the correlations between CT characteristics and pathological subtypes in stageⅠinvasive non-mucinous lung adenocarcinoma,thereby providing imaging evidence for clinical decision-making.Methods:This retrospective study analyzed clinical and CT data from 143 patients with stageⅠinvasive non-mucinous lung adenocarcinoma.Patients were stratified into low-risk(46 cases),medium-risk(67 cases),and high-risk(30 cases)groups.Univariate analysis was used to compare the clinical parameters and CT features across groups,followed by multivariate analysis of significant variables.ROC curve analysis was used to evaluate the diagnostic performance of CT features.Results:There was statistically significant differences in lesion density,pulmonary vascular abnormalities,consolidation-to-tumor ratio(CTR),and non-contrast CT value among the three groups(all P<0.001),while no significant differences were found in the lesion size,lobulation,spiculation,vacuole sign,bronchial abnormalities,or pleural traction sign(all P>0.05).Multivariate logistic regression analysis showed that non-contrast CT value was the independent risk factor for distinguishing between low-risk and medium-risk groups(P=0.004),and between low-risk and high-risk groups(P=0.001).And the high-risk group demonstrated significant association with vascular abnormalities compared to the low-risk group,and the vascular abnormality was the independent risk factor for high-risk group(P=0.009).ROC curve analysis confirmed superior diagnostic performance of non-contrast CT value in subtype differentiation.Conclusions:CT characteristics demonstrate significant diagnostic value in distinguishing pathological subtypes of stageⅠinvasive non-mucinous lung adenocarcinoma,providing valuable imaging references for clinical management.

关 键 词：肺腺癌 体层摄影术 X线计算机 病理亚型 

分 类 号：R73[医药卫生—肿瘤]