肺原位腺癌与微浸润腺癌实性成分鉴别诊断

The differential diagnosis of the real components of the adenocarcinoma in situ and minimally invasive adenocarcinom

目的分析CT影像学表现为肺混杂磨玻璃结节(MGGO)的原位腺癌(AIS)及微浸润腺癌(MIA)中实性成分征象特征及病理基础。方法对CT征象表现为MGGO的20例AIS及20例MIA进行回顾性分析,分别对两组中实性成分的形态、分布、边界、数量及边缘的情况进行对比分析,同时对比组织病理结果。结果 AIS组实性成分呈条索状,似乎成增粗的肺纹理表现,境界较清楚,主要位于磨玻璃病灶的中心,同时病灶边缘无分叶、毛刺、胸膜凹陷等恶性征象。MIA实性成分呈多发斑点状,簇状分布,并有相互聚拢的局势,形态不规则,境界模糊,同时病灶边缘易出现分叶、毛刺、胸膜凹陷恶性征象。结论综合分析AIS及MIA中实性成分的CT表现,对AIS及MIA的诊断与鉴别诊断中有重要价值,实性成分组织病理的特点是两者影像差别的基础。

Objective To analyze CT appearances and pathological basis of the solid components of mixture ground-glass （MGGO） nodules in adenocarcinoma in situ （AIS） and minimally invasive adenocarcinom （MIA）. Methods CT appearing as MGGO of AIS group （20 cases） and MIA group （20 cases） were retrospectively analyzed, and the morphology, distribution, border, number and edge of the solid components in the two groups were analyzed and compared with pathological results. Results The real component of the AIS group was found to be a cord like, it seemed to be a thickening of the lung texture, the state was clear, mainly located in the center of the glass lesions, and the edge of the lesion was not divided leaves, burr, pleural indentation and other malignant signs. MIA solid component showed multiple patchy, cluster distribution and situation of mutual gather, irregular in shape, the realm of vague, also the edge of the lesions prone to lobulation, spiculation, pleural sag signs of malignancy. Conclusion Comprehensive analysis of AIS and MIA in the real components of the CT performance may help to the diagnosis and differential diagnosis of MIA and AIS. The characteristic of the real components of the tissue pathology is the basis of the difference between the two images.