基于高分辨率CT征象预测230例磨玻璃结节样肺腺癌浸润性的临床研究

A clinical study of 230 cases of infiltrating nodular lung adenocarcinoma with ground glass based on high-resolution CT findings

目的:探讨多层螺旋C T对于磨玻璃结节(GGN)样肺腺癌浸润性C T征象的预测价值。方法:回顾性分析230例GGN患者(共242个GGN病灶)的影像征象、病理资料,按照其病理结果将病灶分为浸润性腺癌组和非浸润性腺癌组。比较两组病灶MSCT表现,筛选出具有统计学意义的变量(P<0.05),对其进行二元Logistic回归分析及绘制ROC曲线,计算曲线下面积(AUC),以评估影像征象对于GGN样肺腺癌浸润性的预测价值。结果:两组间病灶分叶征、毛刺征、空泡征、血管集束征、瘤肺界面的发生率存在统计学差异(P<0.05)。二元Logistic回归分析结显示病灶大小及肺瘤界为具有最佳诊断性能的MSCT特征。结论:GGN的大小、边界、分叶征、毛刺征、空泡征、血管集束征等MSCT征象有助于浸润性肺腺癌诊断,其中大小及瘤肺界面具有最佳诊断性能。

Objective To investigate the value of multi-slice spiral CT signs in predicting the invasion of pulmonary adenocarcinoma manifesting as ground glass nodules.Methods The imaging features and pathological data of 230 patients(242 GGN lesions)were retrospectively analyzed.According to the pathological results,the lesions were divided into invasive adenocarcinoma group and non-invasive adenocarcinoma group.Results The incidence of lobulation sign,burr sign,vacuole sign,vascular bundle sign,pleural indentation and tumor lung interface were significantly different between the two groups.Binary logistic regression analysis showed that size of the lesion and the tumor boundary were the best MSCT features.Cnclusion The size,boundary,lobulation sign,glitch sign,vacuole sign,vascular clustering sign were contributed to the diagnosis of invasive lung adenocarcinoma.The size and tumor lung interface have the best diagnostic performance.