CT影像特征及定量参数对肺腺癌纯磨玻璃结节侵袭性的评估价值

Evaluation value of CT image characteristics and quantitative parameters for the invasiveness of pure ground glass nodules of lung adenocarcinoma

目的:探讨CT影像特征及定量参数对肺腺癌相关的纯磨玻璃结节(pGGN)侵袭性的评估价值。方法:回顾性分析郑州人民医院收治的CT表现为pGGN的肺腺癌患者89例,根据肺腺癌分类标准将患者分为浸润前病变组(n=50)和浸润性病变组(n=39),比较两组结节的CT影像特征及定量参数的差异,并分析各参数对病灶浸润性的预测价值。结果:两组间病灶形态、分叶征、毛刺征、血管集束征及空气支气管征特征表现比例差异有统计学意义(P<0.05或P<0.01);浸润前病变组的最大直径、最大横截面积、结节体积及平均CT值均明显低于浸润性病变组(P<0.01)。最大直径、最大横截面积、结节体积及平均CT值诊断浸润性病变的ROC曲线下面积分别为0.783、0.900、0.863及0.779。多因素logistic回归分析发现空气支气管征、最大横截面积及结节体积是浸润性病变的独立影响因素(P<0.05或P<0.01)。结论:空气支气管征、最大横截面积及结节体积较大是肺腺癌pGGN浸润性病变的主要特征。

Objective: To explore the value of CT imaging characteristics and quantitative parameters in evaluating the invasiveness of pure ground glass nodules( p GGN) related to lung adenocarcinoma. Methods: 89 lung adenocarcinoma patients presenting p GGN on CT who admitted to Zhengzhou People’s Hospital were analyzed retrospectively. The patients were divided into pre-invasive lesion group( n = 50) and invasive lesion group( n = 39) according to the classification criteria of lung adenocarcinoma. The differences in the CT image characteristics and quantitative parameters of the nodules between the two groups were compared,and the predictive value of each parameter for lesion infiltration was analyzed. Results: There were statistically significant differences in lesion morphology,lobules,burrs,vascular convergence sign and air bronchial sign between the two groups( P < 0. 05 or P < 0. 01);the maximum diameter,maximum cross-sectional area,nodule volume and average CT value of the pre-invasive lesion group were significantly lower than those of the invasive lesion group( P < 0. 01). The area under the ROC of maximum diameter,maximum cross-sectional area,nodule volume and average CT value for the diagnosis of invasive lesions were 0. 783,0. 900,0. 863 and 0. 779,respectively. Multivariate logistic regression analysis found that air bronchial sign,maximum cross-sectional area and nodular volume were independent influencing factors for infiltrating lesions( P < 0. 05 or P <0. 01). Conclusion: The main characteristics of invasive p GGN of lung adenocarcinoma are air bronchial sign,large maximum cross-sectional area and large nodular volume,.