同时多原发肺腺癌的CT征象与病理分化程度的关系

Relation of CT findings and pathological differentiation of synchronous multiple primary lung adenocarcinoma

目的探讨同时多原发肺腺癌患者的CT征象与病理分化程度的关系。方法回顾性分析37例同时多原发肺腺癌患者的临床资料,共计82个病灶,其中高分化腺癌21个,中分化腺癌38个,低分化腺癌23个。收集并分析患者的CT影像及病理检查资料。结果高分化病灶中毛刺征、胸膜凹陷征的比例分别为57.14%、38.10%,低于中分化和低分化病灶的84.21%、86.84%和91.30%、91.30%,差异均有统计学意义(P﹤0.05);高分化、中分化、低分化病灶中毛刺征、胸膜凹陷征的比例比较,差异均有统计学意义(P﹤0.05);高分化、中分化、低分化病灶中密度为非实性、实性的比例比较,差异均有统计学意义(P﹤0.05);低分化病灶中密度为实性的比例为60.87%,高于中分化、高分化病灶的31.58%、23.81%,差异均有统计学意义(P﹤0.05)。结论不同分化程度的同时多原发肺腺癌患者的病灶密度、毛刺征及胸膜凹陷征存比例在差异,值得进一步研究。

Objective To investigate the relationship between CT findings and pathological differentiation of synchronous multiple primary lung adenocarcinoma.Method The clinical profiles of 37 patients with synchronous multiple primary lung adenocarcinoma were analyzed retrospectively,among them,82 lesions were identified,including 21 well-differentiated adenocarcinoma,38 moderately differentiated adenocarcinoma and 23 poorly differentiated adenocarcinoma,the CT images and pathological data of these patients were collected and analyzed.Result The percentage of spicule sign and pleural indentation sign in well-differentiated lesions were 57.14% and 38.10%,which were significantly lower than those of moderately differentiated and poorly differentiated lesions at 84.21%,86.84% and 91.30%,91.30%,respectively,the differences were statistically significant(P<0.05).The ratio of spicule sign and pleural indentation sign in welldifferentiated lesions,moderately differentiated lesions and poorly differentiated lesions was significantly different(P<0.05).The ratio of solid and non-solid density in lesions of low-,intermediate-and high-grade differentiation showed statistically significant differences(P<0.05);the ratio of solid density in poorly differentiated lesions was 60.87%,which was significantly higher than that of moderately-and well-differentiated lesions at 31.58% and 23.81%,respectively,the difference was of statistical significance(P<0.05).Conclusion The ratio of lesion density,spicule sign and pleural indentation sign in synchronous multiple primary lung adenocarcinoma of varying differentiation are inconsistent,and further study is warranted.