亚厘米纯磨玻璃密度肺腺癌的计算机断层扫描特征及临床意义

Computerized tomography features and clinical significance of sub-centimeter lung adenocarcinoma with pure ground-glass opacity

目的分析亚厘米纯磨玻璃密度肺腺癌的计算机断层扫描(CT)特征及临床意义。方法将100例亚厘米纯磨玻璃密度肺腺癌患者按浸润情况分为浸润组(n=35)和非浸润组(n=65),所有患者均接受胸部CT检查。比较两组患者病灶大小、部位、密度及CT征象。结果浸润组病灶最大径明显大于非浸润组,毛刺征、胸膜凹陷征及血管集束征发生率均明显高于非浸润组,差异均有统计学意义(P﹤0.01)。多因素Logistic分析显示,病灶最大径﹥0.845 cm、有毛刺征及血管集束征为亚厘米纯磨玻璃密度肺腺癌存在浸润性的危险因素(P﹤0.05)。亚厘米纯磨玻璃密度肺腺癌病灶最大径评价浸润性的受试者工作特征(ROC)曲线的曲线下面积为0.867(95%CI=0.797~0.938),cut-off值为0.845 cm,对应灵敏度为83.6%,特异度为76.8%,约登指数为0.604。结论病灶最大径﹥0.845 cm、有毛刺征及血管集束征是亚厘米纯磨玻璃密度肺腺癌存在浸润性的危险因素。

Objective To analyze the computerized tomography(CT)features and clinical significance of sub-centimeter lung adenocarcinoma manifesting as pure ground-glass opacity.Method A total of 100 patients with sub-centimeter lung adenocarcinoma with pure ground-glass opacity were included in the analysis by presence of infiltrations as infiltrating lesions group(n=35)and non-infiltrating lesions group(n=65),all patients were examined with chest CT.The lesion size,site,opacity,and CT signs were recorded and compared between the two groups.Result The maximum diameter of lesions in the infiltrating lesions group was significantly larger than that in the non-infiltrating lesions group,with significantly higher incidence of spiculation,pleural indentation,and vascular convergence sign in the infiltrating lesions group compared to non-infiltrating lesions group(P<0.01).Multivariate logistic analysis showed that,maximum diameter>0.845 cm,presence of spiculation and vascular convergence sign were risk factors for infiltration of sub-centimeter lung adenocarcinoma with pure ground-glass opacity(P<0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)for sub-centimeter lung adenocarcinoma with pure ground-glass opacity was 0.867(95%CI=0.797-0.938),with a cut-off value of 0.845 cm,corresponding to a sensitivity of 83.6%,specificity of 76.8%,and Youden index was 0.604.Conclusion Maximum diameter>0.845 cm,presence of spiculation and vascular convergence sign are risk factors for infiltrating sub-centimeter lung adenocarcinoma with pure ground-glass opacity.