高分辨CT对肺部结节病患者原位癌和浸润性癌的判断价值

The Diagnostic Value of High-Resolution CT in carcinoma in situ and invasive carcinoma of Patients with Pulmonary Sarcoidosis

目的探究高分辨CT对肺部结节病患者原位癌和浸润性癌的判断价值。方法搜集并整理2015年1月至2018年7月我院呼吸内科检查的292例肺部结节病患者作为研究对象,根据病情分为原位癌组110例与浸润性癌组182例,观察患者胸部高分辨CT图像特征、术后病理学资料。结果原位癌组与浸润性癌组大小、密度、混合性磨玻璃结节、血管周围穿行、边缘分页、血管牵拉征比较,差异具有统计学意义(P<0.05)。经Logistic回归分析得出,边缘分页、血管牵拉征是肺部结节病患者原位癌和浸润性癌独立影响因素。ROC曲线表示,肺部结节病患者原位癌和浸润性癌病灶大小临界值0.927cm,曲线下面积为0.691,敏感度78.3%,特异度58.5%。结论高分辨CT能够有效评估肺部结节病患者原位癌和浸润性癌,有利于临床制定手术方案及远期治疗。

Objective To investigate the diagnostic value of high-resolution CT in carcinoma in situ and invasive carcinoma of patients with pulmonary sarcoidosis.Methods A total of 292 patients with pulmonary sarcoidosis in our Department of Respiratory Medicine from January 2015 to July 2018 were selected and classified as research subjects.According to the disease condition,110 patients were in the carcinoma in the situ group and 182 patients in the invasive carcinoma group.High-resolution CT image features and postoperative pathology data were observed.Results The size,density,mixed ground glass nodules,perivascular access,marginal palpation,and vascular traction were significantly different between the carcinoma in the situ group and the invasive carcinoma group (P<0.05).Logistic regression analysis showed that marginal pagination and vascular traction were independent factors influencing carcinoma in situ and invasive carcinoma in patients with sarcoidosis.The ROC curve indicated that the size of the lesions of carcinoma in situ and invasive carcinoma of patients with pulmonary sarcoidosis was 0.927 cm,the area under the curve 0.691,the sensitivity 78.3%,and the specificity 58.5%.Conclusion High-resolution CT can effectively evaluate carcinoma in situ and invasive carcinoma in patients with pulmonary sarcoidosis,which is beneficial to the clinical planning and long-term treatment.