纯磨玻璃密度肺腺癌内血管异常CT表现与病理亚型的相关性

Correlations between Vessel Changes and the Histopathologic Subtypes of Lung Adenocarcinoma with Pure Ground-glass Nodule on Computed Tomography

目的探讨CT上纯磨玻璃密度结节(pGGN)肺腺癌内血管异常改变与病理亚型的相关性。方法收集107例(116个病灶)经病理证实的pGGN肺腺癌患者的CT影像与病理资料,根据血管在pGGN内的表现(包括血管聚集或/和增粗、扭曲)分成两组:无血管改变组和有血管改变组;肺腺癌的病理分型为3组:浸润前病变组、微浸润腺癌组和浸润腺癌组。采用卡方检验分析血管异常改变与病理亚型的关系,血管异常改变与病灶大小及密度之间的关系分别采用秩和检验和t检验。结果 116个pGGN肺腺癌中,浸润前病变组25个、微浸润腺癌组29个、浸润腺癌组62个。其中无血管改变和出现血管改变分别为21和4、14和15、16和46个。浸润前组、微浸润腺癌组与浸润腺癌组血管改变的差异有统计学意义(P=0.000);血管改变与pGGN的直径差异有统计学意义(P=0.000),与p GGN密度无统计学意义(P=0.826)。结论 pGGN肺腺癌中出现血管异常改变与病变浸润性有相关性,且与pGGN的大小相关,而与病变的密度无关。

Objective To investigate the correlations between vessel changes and the histopathologic subtypes of lung adenocarcinoma with pure ground-glass nodule（ p GGN） on computed tomography（ CT）.Methods Totally 107 patients（ 116 lesions） with lung adenocarcinomas with p GGN who had undergone curative resection were included. Vessel changes included vascular convergence and / or vessel dilation or distortion withinthe p GGN. According to the vessel appearances within the p GGN,all patients were categorized into two groups：no change group and change group. Pearson chi-square test was used to analyze the relationships between vessel changes and histopathologic subtypes. Mann-Whitney rank test and t-test were used to identify the relationship of vessels changes with p GGN density and diameter. Results Among these 116 p GGNs,there were 21 without vessel changes and 4 with vessel changes in 25 preinvasive lesions; 14 without vessel changes and 15 with vessel changes in 29 minimally invasive adenocacinomas; 16 without vessel changes and 46 with vessel changes in 62 invasive lung adenocarcinomas. There were statistically significant differences of vessel changes（ P = 0. 000）among histopathologic subtypes. The lesion diameter was significantly different between these two groups（ P =0. 000）,while the lesion density showed no significant difference（ P = 0. 826）. Conclusion Vessel changes may indicate the invasiveness of lung adenocarcinoma with p GGNs and are related with the lesion diameter.