HRCT对磨玻璃密度肺腺癌侵袭程度的预测价值

The predictive value of HRCT in the invasive degree of ground-glass density lung adenocarcinoma

目的探讨HRCT对磨玻璃密度肺腺癌侵袭程度的预测价值。方法选取156例在HRCT表现为磨玻璃密度且经病理证实为早期肺腺癌患者的影像学特征,根据病理结果分成侵袭前病变和侵袭性病变两组,对两组肺结节的影像学征象进行分析。结果纳入分析的156例中侵袭前腺癌56例,侵袭性腺癌100例,结节平均直径、边缘形态(分叶征、胸膜凹陷征)、混杂磨玻璃结节中实性成分比例(C/T比值)在两组中具有统计学意义,P值均<0.05。二元Logistic回归显示结节平均直径、胸膜凹陷征为侵袭性腺癌的重要预测因素,P值<0.05。ROC曲线分析显示肺结节平均直径、C/T比值在预测侵袭性腺癌的曲线下面积、截断点、敏感度、特异度分别是0.829、11.0mm、73.0%、80.4%,0.773、0.625、69.64%、83.33%。结论HRCT对磨玻璃密度肺腺癌的侵袭性具有一定预测价值。

Objective To investigate the predictive value of high-resolution computed tomography(HRCT)in the invasive degree of ground-glass density lung adenocarcinoma.Methods Retrospective analysis was performed on the imaging features of 156 patients with early-stage lung adenocarcinoma demonstrated by glass grinding density on HRCT.According to the pathological results,the patients were divided into two groups preinvasive lesions and invasive lesions,and the imaging signs of pulmonary nodules in the two groups were analyzed.Results Among the 156 patients included in the study,56 were preinvasive lesions and 100 were invasive lesions.The mean diameter,marginal morphology(lobulation sign,pleural depression sign)and proportion of solid components(C/T ratio)in the mixed ground glass nodules were statistically significant in the two groups,with P values<0.05.Binary Logistic regression showed that the mean diameter of nodules and pleural depression sign were important predictors of invasive adenocarcinoma,P<0.05.ROC curve analysis showed that the average diameter of pulmonary nodules and the C/T ratio were 0.829,11.0 mm,73.0%,80.4%,0.773,0.625,69.64%,and 83.33%,respectively,under the curve of predicting invasive adenocarcinoma.Conclusion HRCT has a certain predictive value for the invasiveness of ground-glass density lung adenocarcinoma.