快速生长的周围型小肺癌CT与病理之间相关性临床研究

Rapidly Growing Small Peripheral Lung Cancers Detected by CT:Correlation Between CT Manifestation and Pathological Features

目的探讨快速生长周围型小肺癌的CT影像学特征及其与病理类型之间的关系。方法通过反复CT检查选择快速生长的周围型小肺癌(直径<20mm)12例,评价其CT特征及其与病理类型之间的关系。对每例患者均通过回顾性的方法评价其肿瘤倍增时间和CT影像学特征。结果9例患者呈实体瘤样生长,多数分界清楚、质地均匀、带有毛刺和分叶的软组织密度影,阴影内缺乏支气管充气征和小泡征。其余3例呈浸润性生长,表现为磨玻璃样阴影。12例患者多数为腺癌,少数为鳞状细胞癌和小细胞肺癌。结论多数周围型快速生长的肺癌为腺癌,少数为鳞状细胞癌和小细胞肺癌。这些肺癌多数呈实体瘤样生长,结节内缺乏支气管充气征或小泡征。

Objective To characterize the CT features of peripheral small lung cancers of fast growthing and to correlate such features with pathological findings. Methods 12 peripheral small lung cancers （ 〈 20 mm） of rapid growth detected by repeated low dose CT screening, were evaluated to examine their CT features and to correlate such features with pathological findings. Results Nine of the tumours exhibited a solid tumour growth pattern： most of them showed a well defined, homogeneous, soft tissue density with spicular or lobulated margin. The remaining three tumours exhibited a lepidic tumour growth pattern. They showed ground glass opacity or ground glass opacity with a higher density central zone on CT images. Conclusions Most peripheral small lung cancers of rapid growth were adenocarcinomas. They also included small cell lung cancer and squamous cell carcinoma. The majority showed solid tumour growth pattern and lacked an air bronchogram and/or small air spaces in the nodule.