周围型肺腺癌CT征象与病理组织分化的相关性

Correlation between CT Signs and Pathological Differentiation of Peripheral Lung Adenocarcinoma

目的:探讨原发周围型肺腺癌的CT征象与病理学组织分化程度的关系。方法:回顾性分析83例病理证实的原发周围型肺腺癌的CT表现,比较在低分化和中高分化腺癌中的差异,统计分析采用卡方检验。结果:在中高分化腺癌与低分化周围型肺腺癌之间,瘤体大小、形态、密度、分叶征、毛刺征和胸膜凹陷征的出现率(χ2=16.430、13.327、19.436、6.542、13.005、7.945)有统计学差异(P<0.05),而发生部位、空泡征、支气管气相和血管集束征的出现率(χ2=1.312、0.177、0.027、0.191)无统计学差异(P>0.05)。结论:周围型肺腺癌的CT征象与组织分化程度存在一定的关系。瘤体直径>3cm,形态不规则,实性成分越多,且具有深分叶征、毛刺征和胸膜凹陷征等CT征象的周围型肺腺癌更趋低分化。

Purpose： To study the correlation between CT signs and pathological differentiation degree of peripheral lung adenocarcinoma. Methods： Eighty-three cases with pathologically proved peripheral lung adenocarcinoma were enrolled in our study. The CT features of the lesions were observed, and the correlation between them and pathological differentiation degree was analyzed. The chi-square test was used for the statistical analysis. Results： The CT features of the size, shape, density, the display rate of lobulated sign, spicule sign and pleural indentation sign （chi-square = 16.430, 13.327, 19.436, 6.542, 13.005, 7.945） were with statistical differences between high differentiation adenocarcinomas and poorly differentiated adenocarcinomas （P〈0.05）. While the CT features of tumor location, the display rate of bronchus encapsulated air sign, and vessel convergence sign （chi-square = 1.312, 0.177, 0.027, 0.191） were with no statistical difference between high differentiated adenocarcinomas and poorly differentiated adenocarcinomas （P〉0.05）. Conclusion： There is some relationship between CT signs of peripheral lung adenocarcinoma and their differentiation degree. Features of larger than 3 cm in diameter, irregular shape, with more solid component, and with deep lobulated sign, spicule sign and pleural indentation sign may suggest malignant peripheral lung adenocarcinoma.