薄层CT参数与1~2 cm亚实性结节肺腺癌浸润程度及组织学亚型相关性分析:单中心回顾性研究

The association between the thin-section computed tomography parameters and the invasion and histological subtypes of subsolid nodules measuring 1-2 centimeters in diameter as lung adenocarcinoma:a retrospective study from one single center

目的探讨薄层CT参数与1~2 cm肺部亚实性结节浸润程度及组织学亚型的相关性。方法回顾性分析2014年1月至2017年2月期间薄层CT表现为1~2 cm亚实性肺结节且术后病理证实为腺癌的患者病例资料。结果研究共纳入135例患者,其中23例为纯磨玻璃结节,112例为部分实性结节。pTis/1mi与pT1a/1b/2的结节长径、实性成分长径、实性成分比例、结节CT值和CT值比例,组间比较差异均有统计学意义(P<0.0001)。ROC曲线提示实性成分长径、结节CT值、CT值比例对于浸润程度具有一定的预测价值,AUC值分别为:0.838(0.756~0.919)、0.823(0.729~0.917)、0.820(0.726~0.914)。相比其他组织学亚型,浸润性腺癌中实体亚型和微乳头亚型仅在实性成分长径差异有统计学意义(P=0.024)。结论1~2 cm亚实性肺结节的薄层CT参数在不同浸润程度肺腺癌中存在显著差异,可能具有一定的预测价值。

Objective To investigate the association between the parameters of thin-section computed tomography and the invasion and histological subtypes of subsolid nodules measuring 1-2 centimeters in diameter as lung adenocarcinoma.Methods We retrospectively reviewed the cases with subsolid nodules measuring 1-2 centimeters on thin-section computed tomography and histologically confirmed as lung adenocarcinoma.Results A total of 135 patients were enrolled in this study,including 23 with pure ground glass nodules and 112 with part-solid ground glass nodule.We observed significant differences of nodule size,solid component size,consolidation-to-tumor ratio,nodule attenuation and attenuation ratio(P<0.0001).The receiver operating curve indicated certain predictive value of solid component size,nodule attenuation and attenuation ratio:AUC were 0.838(0.756-0.919)、0.823(0.729-0.917)and 0.820(0.726-0.914),respectively.Of the invasive adenocarcinoma,those with solid or micropapillary components merely showed a significance in solid component size(P=0.024).Conclusion The parameters of thin-section computed tomography of 1-2 centimeters subsolid nodules showed significant differences in varied invasiveness of lung adenocarcinoma,and these could have certain predictive value.