周围型肺癌的病理类型与CT征象相关性研究

The correlation between CT characteristics and pathological types of peripheral pulmonary carcinoma

目的探讨周围型肺癌的CT征象与病理组织学类型的相关性。方法收集手术或活检病理证实的肺内孤立性恶性结节72例进行病理、CT征象的对照研究。结果72例恶性结节中,鳞癌30例、腺癌38例、小细胞癌2例,大细胞癌1例,类癌1例。鳞癌中直径大于3cm者23例,有坏死14例,空洞5例,深分叶14例,毛刺征9例,胸膜凹陷征11例,血管支气管集束征14例,周围结构浸润12例,肺门纵隔淋巴结肿大6例,肺内外转移6例。腺癌中直径大于3cm者12例,有坏死4例,深分叶23例,毛刺征20例,胸膜凹陷征15例,血管支气管集束征21例,周围结构浸润8例,肺门纵隔淋巴结肿大8例,肺内外转移2例。结论肿瘤的大小、坏死、空洞、毛刺征和血管支气管集束征有助于对周围型肺癌组织类型的推断。

Objective To explore the correlation between CT characteristics and pathological types of peripheral pulmonary carcinoma. Methods CT manifestations of 72 patients of peripheral pulmonary carcinomas and Pathological correlation were analyzed. Results All of the 72 cases were confirmed by pre -operation or operation pathologically, including 30 cases of squamous carcinoma, 38 cases of adenocarcinoma, 2 cases of small cell carcinoma, 1 case of large cell carcinoma and 1 case of carcinoid tumor. Thirty cases of squamous cell carcinoma had 14 putrescence, 5 cavity, 14 deep lobulation, 9 spiculation, 11 pleural tag, 14 convergence of vessels and bronchi, 12 surrounding invasion, 6 lymph enlargement, 6 metastasis in or out the lung and 23 more than 3cm in diameter. Four cases of 38 adenocarcinomas showed 4 putrescence, 23 deep lobulation, 20 spiculation, 11 pleural tag, 15 convergence of vessels and bronchi, 8 surrounding invasion, 8 lymph enlargement, 2 metastasis in or out the lung and 12 more than 3cm in diameter. Conclusion The signs of putrescence, cavity, spiculation, convergence of vessels and bronchi and more than 3cm in diameter were valuable to differentiate squamous carcinoma and adenocarcinoma preopearatively