肺磨玻璃样病变侵袭性相关因素分析

Analysis of related factors of invasiveness of ground glass opacity

目的探讨肺磨玻璃样病变(GGO)侵袭性的相关因素。方法 47例CT征象为肺部磨玻璃影的肺腺癌患者,按照GGO实性成分最大径与肺窗测GGO最大径之比(R表示)分组,R≥0.5作为观察组(32例),R<0.5作为对照组(15例)。对比两组患者的临床、影像、病理资料,判断其侵袭性。结果两组患者病灶部位、直径、形状以及边界是否清晰情况比较差异无统计学意义(P>0.05);观察组的边缘分叶和(或)毛刺比例、胸膜凹陷征以及空泡征比例明显高于对照组,差异具有统计学意义(P<0.05);观察组患者的吸烟史和感染史比例(21例和19例)高于对照组(5例和6例),差异有统计学意义(P<0.05)。两组患者淋巴结转移及脉管癌栓比例比较差异无统计学意义(P>0.05);观察组病理分期及胸膜侵犯率高于对照组,差异有统计学意义(P<0.05)。结论 GGO的病灶实性比例越高肿瘤侵袭性越强,CT征象对判断肿瘤侵袭性具有重要价值。

Objective To discuss the related factors of invasiveness of ground glass opacity（GGO）. Methods A total of 47 lung abrasion patient with CT findings of lung ground glass opacity were divided by ratio of the maximum diameter of GGO solid component to the maximum diameter of GGO measured by pulmonary window（R） into observation group（R≥0.5, 32 cases） and control group（R0.5, 15 cases）. The clinical, imaging and pathological data of the two groups were compared, and the invasiveness was evaluated. Results Both groups had no statistically significant difference in lesion location, diameter, shape and boundaries clear or not（P〉0.05）. The observation group had obviously higher proportion of the marginal lobe and（or） burr, pleural indentation sign and vacuole sign ratio than the control group, and their difference was statistically significant（P〈0.05）. The observation group had higher proportion of smoking history and infection history（21 and 19 cases） than the control group（5 and 6 cases）, and their difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in the proportion of lymph node metastasis and vascular tumor thrombus（P〉0.05）. The observation group had higher pathological staging and pleural invasion rate than the control group, and the difference was statistically significant（P〈0.05）. Conclusion The higher the proportion of solid lesions in GGO, the stronger the invasiveness of tumor, and the CT signs shows important value in judging the invasiveness of tumor.