病灶直径和CT值联合评估浸润性肺腺癌的诊断价值

The Combined Evaluation of Lesion Diameter and CT Value in the Diagnosis of Invasive Lung Adenocarcinoma

目的研究病灶直径和CT值联合评估浸润性肺腺癌的诊断价值。方法选取2019年10月-2020年9月我院经病理确诊的67例肺腺癌患者为研究对象,其中浸润前病变组(38例)和浸润性组(29例),均进行CT检查、测定病灶直径,比较两组CT征象差异,采用多因素Logistic回归分析浸润性的危险因素,并采用ROC曲线确定病灶直径、CT值以及病灶直径联合CT值评估浸润性肺腺癌的敏感度、特异度。结果浸润性组病灶直径、CT值均大于浸润前病变组,差异有统计学意义(P<0.05)。浸润性组CT征象实质性成分、边缘多呈分叶征、胸膜凹陷征、空泡或空腔征、空气支气管征检出率高于浸润前病变组,差异有统计学意义(P<0.05),而两组血管集束征检出率比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析显示,病灶直径、CT值是浸润性肺腺癌的危险因素,其数值越大病理证实浸润性肺腺癌可能性越大;ROC曲线分析显示,病灶直径联合CT值诊断浸润性肺腺癌敏感度、特异度均高于病灶直径、CT值诊断方法(P<0.05)。结论病灶直径和CT值是浸润性肺腺癌的独立危险因素,且两者联合评估浸润性肺腺癌诊断率高于单一指标,可为临床鉴别肺腺癌浸润前病变和浸润提供参考。

Objective To study the combined evaluation of lesion diameter and CT value in the diagnosis of invasive lung adenocarcinoma.Methods 67 cases of lung adenocarcinoma patients diagnosed pathologically in our hospital from October 2019 to September 2020 were selected as the research objects.Among them,the pre-invasive lesion group(38 cases)and the invasive group(29 cases)were examined by CT.Measure the diameter of the lesion and compare the difference in CT signs between the two groups,multivariate Logistic regression was used to analyze the risk factors of invasiveness,and ROC curve was used to determine the lesion diameter,CT value,and lesion diameter combined with CT value to evaluate the sensitivity and specificity of invasive lung adenocarcinoma.Results The lesion diameter and CT value of the invasive group were larger than those of the pre-invasive disease group,the difference was statistically significant(P<0.05).Substantial components of CT signs in the infiltrating group,the detection rate of lobular sign,pleural depression,cavitation or cavity sign,and air bronchus sign was higher in the margins than the pre-infiltration group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the detection rate of vascular clustering signs between the two groups(P>0.05).Multivariate Logistic regression analysis showed that lesion diameter and CT value were risk factors for invasive lung adenocarcinoma.The larger the value,the greater the possibility of pathologically confirming invasive lung adenocarcinoma;ROC curve analysis showed that the sensitivity and specificity of lesion diameter combined with CT value in the diagnosis of invasive lung adenocarcinoma were higher than the diagnosis method of lesion diameter and CT value(P<0.05).Conclusion The lesion diameter and CT value are independent risk factors for invasive lung adenocarcinoma,and the diagnosis rate of the two combined evaluation of invasive lung adenocarcinoma is higher than a single index,which can provide references for clinical differentiation of pre-invasive lung adenocarcinoma and invasion.