肺原位腺癌与微浸润腺癌的MSCT表现及对比分析

目的 探讨肺原位腺癌（AIS）和微浸润腺癌（MIA）的MSCT影像特点及区别.方法 回顾性分析2014年1月至2015年8月经手术病理证实的97例患者（共111枚结节）临床资料.结果 肺AIS和MIA的病灶大小分别为（7.4±2.2）mm和（10.4±4.2）mm,差异具有统计学意义（P=0.003）.肺AIS病变中,纯磨玻璃结节20枚,实性结节0枚,MIA病变中,纯磨玻璃结节57枚,实性结节17枚,两个不同病理亚型中磨玻璃结节和实性结节数量差异有统计学意义（P=0.019）.肺AIS和MIA病变间血管贯穿、瘤肺界面、空泡征差异均无统计学意义（P〉0.05）,毛刺征象差异有统计学意义（P=0.039）.两个病理亚型间的胸膜凹陷和分叶征象显示率差异较大.结论 病变大小、密度、毛刺、胸膜凹陷和分叶有助于鉴别肺AIS和MIA.

Objective To analyze the distinction of lung adenocarcinoma in situ（AIS）from minimally invasive adenocarcinoma（MIA） with CT findings. Methods The clinical data of 8 patients（with a total of 111 nodules）confirmed by operation and pathology from January 2014 to 2015 were retrospectively analyzed in 97 cases. Results Mean size of AIS and MIA was（7.4±2.2）mm and（10.4±4.2）mm.There were statistically significant differences between two histopathologic subtypes in terms of lesion size（P=0.003）.Of the 21 AIS,there were 20 pure ground-glass nodules,and 0 solid nodules.Of the 90 MIA,there were 57 pure ground-glass nodules,and 17 solid nodules. There were statistically significant differences in terms of lesion density（P=0.019）. There were no significant differences in terms of lesion vessel changes,lung-tumor interface and presence of bubble-like sign（P〉0.05）. There were statistically significant differences in terms of lesion spiculation sign（P=0.039）. There were differences between two histopathologic subtypes in terms of the percentage of pleural indentation and lobulation sign. Conclusion Lesion size, density,speculation,pleural indentation and lobulation sign may help distinguish AIS from MIA.