对比原发性肺腺样囊性癌与黏液表皮样癌CT表现

Comparison on CT manifestations of primary adenoid cystic carcinoma and mucoepidermoid carcinoma

目的对比原发性肺腺样囊性癌(ACC)与黏液表皮样癌(MEC)CT表现。方法回顾性分析经病理证实的22例ACC(ACC组)与18例MEC(MEC组)患者胸部CT资料,比较其CT表现差异,并对增强动脉期及静脉期CT值绘制受试者工作特征(ROC)曲线,评估其鉴别MEC与ACC的效能。结果ACC组与MEC组间病灶类型,增强扫描动、静脉期CT值及病灶强化程度差异均有统计学意义(P均<0.05);病灶部位、有无阻塞性病变、囊变/坏死、钙化、淋巴结肿大、胸腔积液及远处转移组间差异均无统计学意义(P均>0.05),而中央型病变发生部位、纵向浸润范围及病变环周范围组间差异均有统计学意义(P均<0.05)。ROC曲线显示,动脉期和静脉期CT值鉴别ACC与MEC的曲线下面积(AUC)分别为0.78及0.75。结论ACC和MEC的CT表现存在一定差异,结合临床有助于鉴别诊断。

Objective To comparatively analyze CT manifestations of primary lung adenoid cystic carcinoma(ACC)and mucoepidermoid carcinoma(MEC).Methods Data of chest CT of 22 patients with ACC(ACC group)and 18 with MEC(MEC group)confirmed pathologically were retrospectively analyzed.CT manifestations were compared between groups.The receiver operating characteristic(ROC)curves of CT values of enhanced arterial and venous phases were drawn,and the areas under the curves(AUC)for differential diagnosis of MEC and ACC were calculated,and the diagnostic efficacies were evaluated.Results There were significant differences of lesion types,CT values of enhanced arterial and venous phases and enhanced degrees between groups(all P<0.05),while the localization,occurrence of obstructive lesions,cystic degeneration/necrosis,calcifications,lymph nodes enlargement,pleural effusion and metastases were not statistically different between groups(all P>0.05).For central type lesions,there were statistical differences of the localization of occurrence,longitudinal infiltration range and lesion circumference range between groups(all P<0.05).ROC curves showed that AUC of the arterial and venous CT value was 0.78 and 0.75,respectively.Conclusion CT manifestations of ACC and MEC were somehow different,being helpful to differential diagnosis combining with clinic data.