肺浸润性腺癌各病理亚型的临床资料及CT征象分析

Analysis of clinical data and CT signs of various pathological subtypes of invasive lung adenocarcinoma

目的:总结肺浸润性腺癌病理亚型的临床资料及影像学征象,并通过影像特征提示病理亚型,从而实现术前对手术术式选择及临床预后的初步预判。方法:选取江南大学附属医院手术切除的单发肺结节患者89例,术前均行高分辨率计算机体层摄影术(HRCT)检查,术后记录病理结果。收集入组患者的一般临床资料,并完成HRCT特征提取;比较肺浸润性腺癌病理亚型的临床资料及影像学特征。结果:本研究肺浸润性腺癌患者中,病理结果为贴壁生长型11例,腺泡型60例,乳头型8例,微乳头型3例,实体型7例。各病理亚型在吸烟史、结节形态、边界、分叶、血管集束征、支气管截断和内部小支气管增宽方面比较,差异均无统计学意义(P>0.05);各病理亚型在性别、密度、毛刺、胸膜凹陷征及空泡方面比较,差异均有统计学意义(P<0.05)。结论:肺浸润性腺癌的密度、毛刺、胸膜凹陷征及空泡对其病理亚型的预测及手术方案的确定具有临床应用价值。

Objective:To summarize the clinical data and imaging features of pathological subtypes of invasive lung adenocarcinoma,and to achieve preliminary predictions of surgical plans and clinical prognosis by deducing pathological subtypes from imaging features.Methods:89 patients with single pulmonary nodule underwent surgical resection in the Affiliated Hospital of Jiangnan University.All patients were examined by high-resolution computed tomography(HRCT).Clinical data and HRCT imaging features of lung invasive adenocarcinoma different pathological subtypes were compared.Results:In this study,there were 11 patients of the adherent growth type,60 patients of the acinar type,8 patients of the papillary type,3 patients of the micropapillary type,and 7 patients of the entity type.There were no significant differences in smoking history,nodule shape,border,lobulation,vascular bundle sign,bronchial truncation and internal bronchial broadening among the pathological subtypes(P>0.05);there were significant differences in sex,density,burr,pleural indentation sign and vacuole among the pathological subtypes(P<0.05).Conclusion:The density,burr,pleural indentation sign and vacuoles of lung invasive adenocarcinoma have clinical application values in predicting the pathological subtype and determining the surgical plan.