磨玻璃结节肺腺癌患者CT征象及病理特点分析

Analysis of CT Signs and Pathological Features in Patients With Ground-Glass Nodules and Lung Adenocarcinoma

目的探讨磨玻璃结节肺腺癌患者CT征象及病理特点。方法采用回顾性研究方式收集CT检查且经病理检查确诊为磨玻璃结节肺腺癌患者的临床资料,包括影像学资料及病理资料。共纳入符合标准的资料72例,按照病例分型,将患者分为3组:浸润前病变(A组)、微浸润腺癌(B组)、浸润性腺癌(C组),分析不同病理分型患者的CT特征,包括定量指标(平均CT值、病灶体积、最大直径)及定性指标(图像表现)并进行比较。结果C组的CT征象中,以欠均匀、不均匀为主,且边界不清晰,边缘呈毛刺状,上述征象指标均与A、B两组征象分布差异显著(P<0.05);C组患者CT征象表现为密度均匀、瘤肺边界清晰、边缘毛刺风险分别是非C类型(A、B两种类型)的1.232倍、3.774倍、17.857;C组平均CT值(-318.45±150.62)HU,显著高于A、B两组(-553.06±128.37)HU、(-568.94±135.41)HU(P<0.05);C组的病灶体积、最大直径则高于A、B两组(P<0.05)。结论磨玻璃结节肺癌患者CT征象与肺腺癌病理分类有一定联系,其中瘤肺边界清晰、毛刺状及CT定量参数可作为预测因子。

Objective To investigate the CT signs and pathological features in patients with ground-glass nodules and lung adenocarcinoma.Methods Using a retrospective research method,clinical data were collected among patients who underwent CT examinationand were diagnosed as ground-glass nodules and lung adenocarcinoma by pathological examination,including imaging data and pathological data.A total of 72 cases of data that met the criteria were included.According to the case classification,the patients were divided into three groups:preinvasive lesions(group A),minimally invasive adenocarcinoma(group B)and invasive adenocarcinoma(group C).The CT features were analyzed and compared among patients with different pathological types,including quantitative indicators(average CT value,lesion volume,maximum diameter)and qualitative indicators(image manifestations).Results The CT signs of group C were mainly less even and uneven,with unclear borders and burr-like edges.The above signs were significantly different from those of sign distribution of groups A and B(P<0.05).CT signs of patients in group C were 1.232 times,3.774 times and 17.857 times of the non-C type(A type and B type)in terms of uniform density,clear tumor lung boundary and burr edge risk respectively.The average CT value of group C was significantly higher than that of group A and group B[(-318.45±150.62)HU vs.(-553.06±128.37)HU vs.(-568.94±135.41)HU](P<0.05).The lesion volume and maximum diameter in group C were higher than those in group A and group B(P<0.05).Conclusion CT signs of patients with ground-glass nodules and lung cancer have a certain relationship with the pathological types of lung adenocarcinoma.The clear tumor lung boundary,burr shape and CT quantitative parameters can be used as predictors.