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)在孤立性亚实性肺腺癌结节影像分期中的价值。方法:搜集LDCT筛查发现并经病理学检查证实的亚实性肺腺癌结节53例,其中男性19例,女性34例,平均年龄55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对亚实性肺腺癌结节影像T和N分期的准确率分别为88.7%(47/53)和94.3%(50/53)。影像与病理分期及不同胸部影像科医师之间影像分期的一致性良好(Kappa=0.803,0.733;P<0.05)。结论:亚实性肺腺癌结节多为早期肺癌,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 adenocarcinoma. Methods: A total of 53 patients [19 male and 34 female; mean age of 55 years] with solitary subsolid nodular lung adenocarcinoma 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 adenocarcinoma between different radiologists. Lymph node metastasis and distant metastasis diagnosed by LDCT were compared with histopathological findings. Results: The accuracy of LDCT in T 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 metastasis and distant organ metastasis.