64排螺旋CT对肺癌合并肺内结节的2年随访研究

Follow-up study for 2 years on brilliance 64 slice CT in treating lung cancer complicated with pulmonary nodules

目的通过利用64排螺旋CT分析肺癌合并肺内小结节的结节性质。方法回顾性分析2010年1月-2012年6月在北京大学肿瘤医院收治的41例肺癌同时合并肺内小结节患者的临床资料,经过2年随访,分析原发性肺癌的分期以及与肺内小结节的位置的关系,原发病灶与小结节边缘之间的距离的关系,并分析肺癌合并肺内小结节的性质和特点。结果 41例肺癌合并肺内小结节患者中,结节呈恶性进展表现患者17例（41.46%）,肺内结节稳定考虑良性患者24例（58.54%）。Ⅰ期肺癌患者肺内小结节恶性发生率显著低于其他肺癌分期恶性发生率（P〈0.05）。原发病灶相同肺叶与不同肺叶（同侧肺野、对侧肺野）的肺内小结节恶性发生率差异无统计学意义（P〈0.05）,原发病灶同侧肺野肺内小结节恶性发生率显著高于对侧肺野恶性发生率（P〈0.05）。距离原发病灶≤1.5 cm的肺内小结节间恶性发生率为77.78%（7/9）显著高于距离原发症灶1.5-4.5 cm、≥4.5 cm的肺内小结节间恶性发生率（P〈0.05）,距离原发病灶1.5-4.5 cm的肺内小结节恶性发生率明显高于距离原发病灶≥4.5cm的肺内小结节（P〈0.05）。结论肺癌不同分期、肺内小结节在肺内的位置以及与原发病灶之间的距离,对于判断肺内小结节的性质具有重要的参考价值。

Objective To analyze the nature of the nodules in lung cancer complicated with pulmonary nodules by Brilliance 64 slice CT. Methods The clinical data of 41 patients with lung cancer combined with pulmonary nodules treated in Peking University Cancer Hospital from January 2010 to June 2012 were retrospectively analyzed. After 2 years follow-up, the staging of the primary lung cancer, relation between it and locations of the pulmonary nodules, relation between the primary lesions and the distance of nodules edges were analyzed, the nature and features of lung cancer complicated with pulmonary nodules were analyzed. Results Among the 41 patients with lung cancer combined with pulmonary nodules, 17 cases（41.46%） had malignant progression performance in the nodules, and 24（58.54%） cases had stable pulmonary nodules and thus were considered benign patients. Among the Stage Ⅰ patients with lung cancer, the malignance incidence of the pulmonary nodules was significantly lower than that of patients in other sages（P 〈0.05）.There is no statistical difference between the malignance incidences of pulmonary nodules of the same lung lobe and those of different lobes（the ipsilateral lung field, the contralateral lung field） in primary lesions（P 〈0.05）. The malignance incidence of the pulmonary nodules in the ipsilateral lung field in primary lesions was significantly higher than that in the contralateral lung field（P 〈0.05）. The internode malignance incidence of the pulmonary nodules at ≤1.5 cm from the primary lesions was 77.78%（7/9）, which was significantly higher than that of the pulmonary nodules at 1.5-4.5 cm or ≥4.5 cm from the primary lesions（P 〈0.05）. The malignance incidence of the pulmonary nodules at 1.5-4.5 cm from the primary lesions was significantly higher than that of the nodules at distance ≥ 4.5 cm from the primary lesions（P 〈0.05）.Conclusion Different lung cancer stages, the locations of the pulmonary nodules and the distance between the nodules and the primary lesions are of important reference value for judging the nature of the pulmonary nodules.