原发性肺黏液表皮样癌的CT特征及与病理分级的对照研究

CT features of primary pulmonary mucoepidermoid carcinoma and the comparative study with pathological grade

目的分析归纳原发性肺黏液表皮样癌(PMEC)的CT表现,对比高级别与低级别原发性肺黏液表皮样癌CT特征,进一步提高对本病的认识。方法回顾性分析经手术病理确诊为PMEC,术前均进行过CT扫描(18例行CT平扫及增强扫描,2例行CT平扫),且临床和病理资料完整的20例患者。分析其CT表现,包括肿瘤的位置、大小、形态、边缘、密度、强化特点及阻塞性改变。采用Fisher确切概率法比较分析不同病理级别的PMEC的CT特点。结果 20例PMEC均为肺内单发病灶,以中央型居多(15例),在CT平扫上出现超过55%的征象:圆形或类圆形(11例)、边缘清楚(13例)、密度均匀(11例)、不同程度的肺内阻塞性改变(17例);增强CT中有约60%的病灶呈中度以上强化。20例PMEC的病理分型为低级别13例,高级别7例,低级别PMEC组与高级别PMEC组的位置、边缘、密度均一性和强化方式比较,差异有统计学意义(P<0.05),病灶形状及肺内阻塞性改变无统计学意义(P>0.05)。结论 PMEC的CT表现具有一定特点,根据肿瘤的位置、边缘、密度均一性及强化特点等可以预测其病理分级。

Objective To analyze and summary the CT findings of primary pulmonary mucoepidermoid carcinoma （PMEC）, and to compare the CT features of high grade and low grade primary pulmonary mueoepidermoid carcinoma in order to further improve the understanding of this disease. Methods A total of 20 bases of PMEC diagnosed by surgical pathology with complete clinical and pathological data who underwent CT scans （18 cases of routine CT scan and en- hanced scan, 2 cases of CT routine scan）before surgery were retrospectively analyzed. The CT findings including the lo- cation of the tumor, the size, shape, edge, density, enhancement characteristics and obstructive changes were analyzed. The CT characteristics of PMEC with different pathological grades were compared by Fisher exact test. Results 20 cases of PMEC were pulmonary single lesions, mostly in the central type （15 cases）. More than 55% of the signs appearing on CT included round or oval（11 cases）, clear edge （13 cases）,density uniformity（ll cases）, varying degrees of obstructive lung changes （17 cases）. Approximately 60% of the enhanced CT lesions were more than moderately enhanced. The pathologic classification of 20 cases of PMEC was low-grade in 13 cases and high-grade in 7 cases.There were signifi- cant differences in the location, edge, density uniformity,enhancement characteristics between the low-grade PMEC group and high-grade PMEC group （P〈0.05）. There were no significant differences in lesion shape and pulmonary ob- structive change between the two groups（P〉0.05）. Conclusion The CT manifestations of PMEC have certain character- istics, and the pathological grade can be predicted according to the location, edge, density uniformity and enhancement characteristics of tumor.