肺微浸润性腺癌影像学特征及临床病理分析

Imaging features and clinicopathological analysis of 23 cases of lung minimally invasive adenocarcinoma

目的探讨肺微浸润性腺癌(MIA)影像学特征和临床病理特点。方法回顾性分析安徽省立医院2016年1~12月确诊的23例MIA临床资料、影像学表现、病理组织学形态、免疫表型等,并进行相关文献复习。结果 23例MIA患者16例女性,7例男性,患者多为不吸烟人群。CT显示病灶为混杂/混合密度结节,平均直径1.2 cm,结节形态不规则、密度不均可见实性区域,边缘出现胸膜凹陷和血管集束征。肉眼观,MIA是一个境界清楚的灰白色、灰褐色结节,直径0.5~2.0 cm,质地较正常肺组织韧。镜下,癌细胞紧贴支气管壁或肺泡壁排列,局部出现乳头状、腺泡状结构的微浸润灶,微浸润灶直径0.2~0.5 cm。结论 MIA通常为直径小于3 cm的孤立性小腺癌,且微浸润灶的最大直径≤0.5 cm,无间质、血管和胸膜侵犯。

Objective To investigate the imaging and clinicopathological features of minimally invasive adenocarcinom （ MIA ） . Methods A total of 23 MIA cases from Jan. 2016 to Dece. 2016 were selected. The clinical data, radiological and pathological characteris-tics were retrospectively analyzed. The related literature was reviewed as well. Results 16 of the 23 cases were female and 7 were male. Very few of them were smokers. CT scan revealed the mixed density irregular nodules with solid components in lesions and an average size of 1.2 cm. And the depressing pleura and concentrations could be seen in the edge of the mass. Grossly, masses were circumscribed gray brown and gray white, with diameters from 0. 5cm to 2. 0cm, and tougher than the normal lung tissues. Light microscopic evaluation showed that the tumor cells were attached to the bronchial wall or the alveolar wall, appearing papillary structure, acinar structure in the minimally invasive le-sion, which ranged from 0. 2cm to 0. 5cm in diameter. Conclusion Usually MIA is small, less than 3cm in diameter, and isolated. Any in-vasive lesion is less than 0.5cm in diameter, without the interstitial vascular and pleura invasion.