印戒征型囊性肺癌的影像及临床病理特征

Imaging and clinicopathological features of signet ring cystic lung cancer

目的分析印戒征型囊性肺癌的影像及临床病理特征。方法回顾性分析本院2016年1月至2019年12月年23例经胸部CT及手术确诊的囊性肺癌患者的CT特征及临床及病理资料,根据是否有印戒征表现分为印戒征型囊性肺癌组和其他类型囊性肺癌组。结果印戒征型囊性肺癌的患者9例,其他类型囊性肺癌患者14例,影像学方面,病变部位均为周围型,印戒征型囊性肺癌在CT上出现磨玻璃成分及囊内分隔的比例较其他类型少(P<0.05),两者在边缘形态及邻近结构等方面无显著差异;病理均为腺癌,其中印戒征型囊性肺癌以乳头状为主型腺癌和腺泡样为主型腺癌多见,而其他类型囊性肺癌主要以贴壁生长为主型腺癌多见(P<0.05),所有患者均无淋巴结转移,但印戒征型囊性肺癌出现脉管内癌栓比例显著高于其他类型(P<0.05);基因突变方面,两者无显著差异。结论印戒征型囊性肺癌是囊性肺癌的一种特殊类型,其形态学表现与肿瘤浸润性生长有关,通常提示肿瘤进展。

Objective To analyze the imaging and clinicopathological features of cystic lung cancer with signet ring syndrome.Methods The CT features and clinical and pathological data of 23 patients with cystic lung cancer diagnosed by chest CT and surgery in our hospital from January 2016 to December 2019 were analyzed retrospectively.They were divided into signet ring sign type cystic lung cancer group and other types of cystic lung cancer group according to whether they had signet ring sign or not.Results There were 9 patients with signet ring type cystic lung cancer and 14 patients with other types of cystic lung cancer.In terms of imaging,the lesions were peripheral type.The proportion of ground glass composition and intracapsular septum on CT of signet ring type cystic lung cancer was less than that of other types.There was no significant difference in marginal morphology and adjacent structures between the two types.The pathology was adenocarcinoma,among which papillary adenocarcinoma and acinar adenocarcinoma were the most common in signet ring type cystic lung cancer,while adherent growth was the main type in other types of cystic lung cancer(P<0.05).All patients had no lymph node metastasis.however,the proportion of intravascular tumor thrombus in signet ring type cystic lung cancer was significantly higher than that in other types(P<0.05).There was no significant difference in gene mutation between the two types.Conclusion Seal ring type cystic lung cancer is a special type of cystic lung cancer.Its morphological manifestation is related to tumor invasive growth and usually indicates tumor progression.