磨玻璃结节样多灶性肺腺癌CT征象与分化程度和淋巴结转移的关系

Relationship Between CT Signs and Differentiation Degree and Lymph Node Metastasis of Ground-Glass Nodular Multifocal Lung Adenocarcinoma

目的:探究磨玻璃结节样多灶性肺腺癌(MLA)CT征象与分化程度和淋巴结转移的关系。方法:回顾性分析2016年1月至2021年7月于我院收治的156例MLA患者临床资料。根据患者分化程度、淋巴结转移情况进行分组,分别分为高分化亚组(n=48)、中分化亚组(n=65)、低分化亚组(n=43)及转移亚组(n=81)、未转移亚组(n=75)。比较不同分化程度、转移情况亚组MLA患者的CT征象差异,使用Spearman相关性分析探究CT征象与分化程度和淋巴结转移的关系。结果:高分化亚组患者≥3cm的病灶出现率低于低分化亚组;高分化亚组患者的pGGN出现率高于中、低分化亚组;高分化亚组毛刺征、分叶征、空洞征、血管集束征、胸膜凹陷征出现率低于低分化亚组;中分化亚组患者血管集束征出现率均低于低分化亚组(P均<0.05)。经Spearman相关性分析,MLA患者病灶长径与分化程度负相关(r=-0.337,P<0.05)。转移亚组与未转移亚组病灶长径≥3cm及圆形或类圆形、分叶征、血管集束征出现率存在显著差异(P均<0.05),两组患者pGGN、毛刺征、空洞征、胸膜凹陷征出现率差异不显著(P均>0.05);经Spearman相关性分析,MLA患者病灶长径与淋巴结转移相关(r=0.429,P<0.05)。结论:病灶长径及pGGN、毛刺征、分叶征、空洞征、血管集束征、胸膜凹陷征出现率与分化程度相关,病灶长径、圆形或类圆形出现率、分叶征出现率、血管集束征出现率与淋巴结转移相关,根据MLA患者部分CT征象可对分化程度和淋巴结转移进行初步判断。

Objective:To explore the relationship between CT signs and differentiation degree and lymph node metastasis of ground-glass nodular multifocal lung adenocarcinoma(MLA).Methods:The clinical data of 156 patients with MLA treated in the hospital between January 2016 and July 2021 were retrospectively analyzed.Patients were grouped according to the differentiation degree and lymph node metastasis into high differentiation subgroup(n=48),moderate differentiation subgroup(n=65),low differentiation subgroup(n=43),metastasis subgroup(n=81)and non-metastasis subgroup(n=75).The differences in CT signs were compared among patients with MLA of different differentiation degrees and metastasis status,and spearman correlation analysis was used to explore the relationship between CT signs and differentiation degree and lymph node metastasis.Results:The occurrence rate of lesions≥3cm in high differentiation subgroup was lower than that in low differentiation subgroup.The occurrence rate of pGGN in high differentiation subgroup was higher than that in moderate and low differentiation subgroups.The occurrence rates of spicule sign,lobulation sign,cavitation sign,vascular convergence sign and pleural indentation in high differentiation subgroup were lower than those in low differentiation subgroup.The occurrence rate of vascular convergence sign in moderate differentiation subgroup was lower than that in low differentiation subgroup(all P<0.05).According to spearman correlation analysis,the length of the lesion in patients with MLA was negatively correlated with the differentiation degree(r=-0.337,P<0.05).There were significant differences in the length of the lesion≥3cm and occurrence rates of round or round-like shape,lobulation sign and vascular convergence sign between metastasis subgroup and non-metastasis subgroup(all P<0.05),but there were no statistical differences in the occurrence rates of pGGN,spicule sign,cavitation sign and pleural indentation between the two subgroups(all P>0.05).By spearman correlation analysis,the length of the lesion in patients with MLA was related to lymph node metastasis(r=0.429,P<0.05).Conclusion:The length of the lesion and occurrence rates of pGGN,spicule sign,lobulation sign,cavitation sign,vascular convergence sign and pleural indentation are related to the degree of differentiation.The length of the lesion and occurrence rates of round or round-like shape,lobulation sign and vascular convergence sign are related to lymph node metastasis.According to some CT signs of patients with MLA,differentiation degree and lymph node metastasis can be preliminarily judged.