不同年龄段肺炎型肺癌患者的高分辨率CT表现及病理分析

High Resolution CT Manifestations and Pathological Features of Pneumonia Type Carcinoma of Lung in Different Ages

目的探讨不同年龄段肺炎型肺癌患者的高分辨率CT特点及与病理表现。资料与方法 36例经病理证实的肺炎型肺癌患者,分为中青年组(<60岁,14例)及老年组(≥60岁,22例),比较两组患者的影像特征及病理表现。结果中青年组患者影像学分型以单纯磨玻璃密度影、混合磨玻璃结节及单纯肺叶或段实变为主,共10例;老年组患者影像学分型以混合阴影、实变合并肿块或单纯肺叶或段实变为主,共19例,两者差异有统计学意义(χ2=12.103,P<0.05);与中青年组比较,老年组患者影像学征象中病灶外周分布、均匀实变及叶间裂突出的出现率明显增高(χ2=3.859、5.719、12.837,P<0.05);中青年组患者不均匀实变率明显高于老年组(χ2=5.719,P<0.05);随访6个月后,老年组患者病变的变化率为15.4%,显著低于中青年组的71.4%(χ2=11.137,P<0.05)。结论中青年肺炎型肺癌患者的主要影像学表现为单纯磨玻璃密度影、伴有实性成分的混合磨玻璃结节,以单纯肺叶或肺段实变影为主;老年肺炎型肺癌患者的影像学特征主要为病灶外周分布、均匀实变及叶间裂突出,病情进展慢,应及早进行病理检查确诊。

Purpose To explore the high resolution CT （HRCT） manifestations and pathological features of pneumonia type carcinoma of lung （PTCL） patients with different ages. Materials and Methods Thirty-six patients with pathology-proven PTCL were selected, and divided into young and middle age group （〈60 years, n=14） and old age group （ _〉 60 years, n=22）, the image manifestations and pathological features of PTCL in both groups were compared. Results The main types of PTCL in young and middle age group were pure ground-glass nodule, mixed ground-glass nodule and simple pulmonary segmental and pulmonary lobar consolidations （n=10） and the main types of PTCL in old age group were mixed morphogenetie shadows, eonsolidations with fibroses and masses and simple pulmonary segmental and pulmonary lobar consolidations （n-19）, with significant difference between the two groups X2=12.103, P〈0.05）. The frequency rate of peripheral distribution of lesions, unitbrmity consolidation and protrusion interlobar fissure in old age group were higher than those in young and middle age group with significant difference （X2=3.859, 5.719, 12.837, P〈0.05）, and the frequency of heterogenous consolidation in young and middle age group was higher than that of old age group （X2=5.719, P〈0.05）. The change rate of lesions in old age group was lower than that in young and middle age group alter six months follow-up （X2=11.137, P〈0.05）. Conclusion The main type of patients PTCL in young and middle age are pure ground-glass nodule, mixed ground-glass nodule and simple pulmonary segmental and pulmonary lobar consolidations; and the main image features of old age group are peripheral distribution of lesions, uniformity consolidation and protrusion interlobar fissure, which have the low change rate of lesions, and pathology examination should be early underwent for definite diagnosis.