肺腺癌亚实性结节的影像特征与病理对照分析

A comparative analysis of subsolid nodules imaging features of MSCT and pathology in lung adenocarcinoma

目的:探讨肺腺癌亚实性结节的MSCT表现与病理分类的相关性。方法:收集经手术切除、病理诊断为肺腺癌的亚实性结节133例,直径<3 cm,其中不典型腺瘤样增生(AAH)11例,原位癌(AIS)35例,微浸润性腺癌(MIA)40例,浸润性腺癌(IPA)47例。各病理亚型结节的大小、密度采用逐步判别分析与单因素方差分析,结节的边缘特征(毛刺、分叶、棘突)、形态(类圆形、不规则形)、瘤-肺界面(光滑、毛糙)、空泡征、胸膜凹陷征、支气管改变(充气支气管征、支气管截断)、血管集束征、实性成分组采用卡方检验分析。结果:133例病变的空泡征、胸膜凹陷征、棘突、毛刺、支气管改变、实性成分、瘤-肺界面、密度在AIS、MIA、IPA亚组间差异均有统计学意义(均P<0.05)。血管集束征、形态在各病理组间差异均无统计学意义(均P> 0.05)。结论:病变大小、密度、边缘特征、瘤-肺界面、空泡征、胸膜凹陷征、支气管改变、实性成分有助于区分浸润前病变、微浸润病变和浸润性病变。

Objectlve：To explore the correlation between classification of the adenocarcinoma of the lung. Methods： the imaging features of the subsolid nodules and the pathological 133 cases of subsolid nodules were diagnosed as lung cancer after surgical resection,its diameter were less than 3 cm,ll cases of atypical adenomatous hyperplasia （AAH）,35 cases of carcinoma in situ （AIS）,40 cases of micro invasive adenocarcinoma （MIA）,47 cases of infiltration adenocarcinoma （IPA）. Size and den- sity of the pathological subtype of nodules used by stepwise discriminant analysis and single factor analysis of variance ;edge features of nodules （burr,lobulation, spinous process）, morphology （round , irregular） , lung tumor interface （clear, coarse）, vacuole sign,pleural indentation syndrome,bronchial changes （air bronchogram,bronchial truncation） and vascular convergence sign,solid component by chi square test. Results：The pathological subtype lesions in leaf,vacuole sign,pleural indentation,bronchial changes,solid component,coarse lung tumor interface were statistically significant （P〈0.05）. There was no significant difference in vascular changes and morphology （all P〉0.05）. Conclusion：Lesion size,density,edge characteristics,tumor and lung interface, vacuole sign,pleural indentation,bronchial changes and solid component are helpful for differentiating preinvasive lesions,mi- croinvasive lesions and infiltrative lesions.