多层螺旋CT结合病理特征分析肺内纯磨玻璃结节与侵袭性肺癌的关系

The relationship between pure ground glass nodules in lung and invasive lung cancer by multi-slice spiral CT combined with pathological features

目的多层螺旋计算机断层成像(Computed Tomography,CT)结合病理特征分析肺内纯磨玻璃结节与侵袭性肺癌的关系。方法选取120例经病理证实为肺内纯磨玻璃结节患者,依据病理结果差异分为浸润性组(n=38)、微浸润组(n=30)、浸润前组(n=52),回顾性分析患者临床资料及多层螺旋CT表现。结果 3组患者性别、年龄、病灶部位、平均CT值、病灶形态、毛刺征、充气支气管征比较差异无统计学意义(P> 0. 05)。结节大小:浸润前组<微浸润组<浸润性组(P <0. 05);浸润性组分叶征、空泡征、胸膜凹陷征及血管改变所占比例高于浸润前组与微浸润组,瘤肺界面清晰光整所占比例低于浸润前组与微浸润组(P <0. 05)。纯磨玻璃结节大小与侵袭性肺癌发生呈正相关(r=0. 546,P <0. 05)。结论肺内纯磨玻璃结节患者多层螺旋CT结合病理特征对评估结节侵袭程度可提供重要指导,边缘分叶征、空泡征、胸膜凹陷征及血管改变属于鉴别侵袭性肺癌主要因素,结节大小与侵袭性肺癌呈正相关。

To analyze the relationship between pure ground glass nodules in lung and invasive lung cancer by multi-slice spiral computed tomography(CT)combined with pathological features.One hundred and twenty patients with pure ground glass nodules in lung confirmed by pathological examination were selected.They were divided into invasive group(n=38),micro-invasive group(n=30)and pre-invasive group(n=52)according to the pathological results.The clinical data and multi-slice spiral CT findings were retrospectively analyzed.There was no significant difference in gender,age,lesion location,mean CT value,lesion morphology,spicule sign or aerated bronchial signs among the three groups(P>0.05).Nodule sizes in the pre-invasive group were smaller than that in the micro-invasive group which was smaller than that in the invasive group(P<0.05).The proportions of lobulation sign,vocule sign,pleural indentation sign and vascular changes in the invasive group were significantly higher than those in the pre-invasive group and the micro-invasive group(P<0.05),while the proportion of clear and smooth tumor-lung interface with 57.89%was significantly lower than that in the pre-invasive group and the micro-invasive group(P<0.05).The size of pure ground glass nodules was positively correlated with invasive lung cancer(r=0.546,P<0.05).Multi-slice spiral CT combined with pathological features of patients with pure ground glass nodules in the lung can provide important guidance for assessing the degree of nodule invasion.Edge lobulation sign,vocule sign,pleural indentation sign and vascular changes are the main factors for identification of invasive lung cancer.The nodular size is positively correlated with invasive lung cancer.