低剂量CT对亚实性肺腺癌结节影像分期的研究

Image staging of subsolid nodular lung adenocarcinoma by low-dose CT

目的评价低剂量CT（low-dose CT，LDCT）在亚实性怖腺癌结节影像分期中的价值。方法搜集LDCT筛查发现并经病理证实的亚实性怖腺癌结节53例，其中男性19例，女性34例，平均年龄（55±68）岁。采用Kappa检验回顾性分析影像与病理分期的一致性，以及不同胸部影像科医师之间影像分期的一致性。结果LDCT行亚实性怖腺癌结节影像T和N分期的准确率分别为88.7％（47／53）、943％（50／53）。影像与病理分期及不同胸部影像科医师影像分期的一致性良好（Kappa=0.803，0.733；P〈005）。结论亚实性怖腺癌结节多为早期怖癌，淋巴结或远处转移发生率低，LDCT适用于其术前影像分期。

Objective： To determine the value of low dose CT （LDCT） in the preoperative staging of solitary subsolid nodular lung adenocaxcinoma. Methods： A total of 53 patients[19 male and 34 female; mean age of （55 ± 6.8） years ] with solitary subsolid nodules who underwent LDCT before surgery or needle biopsy were included. The CT findings were assessed in terms of nodule size, density and relationship with pleura. Kappa test was used to analyze the consistency between CT-TNM and p-TNM or staging diagnosis of subsolid nodular lung adenocorcinoma between different radiologists. Lymph node and distant metastasis diagnosed by LDCT were compared with histopathologic findings. Results： The accuracy ofT staging and N staging of subsolid nodular lung adenocarcinoma was 88.7% （47/53） and 94.3% （50/53）, respectively. There was a good consistency between CT-TNM and p-TNM or different radiologists （Kappa=0.803, 0.733; P〈0.05）. Conclusion： LDCT has clear advantages in the image staging of solitary subsolid lung adenocarcinoma because of the low incidences of lymph node and distant organ metastasis.