孤立性肺部分实性结节CT影像表现与肺腺癌病理亚型对照分析

Comparative analysis of CT imaging findings of isolated partial solid pulmonary nodules and pathological subtypes of lung adenocarcinoma

目的:对比分析孤立性肺部分实性结节CT影像表现与病理在临床诊断中的作用。方法:对2019年7月—2021年6月内江市第一人民医院诊疗的74例孤立性肺部分实性结节患者的CT影像及病理资料进行回顾性分析。经肺肿瘤新分类标准分为浸润前病变(15例)、微浸润腺癌(21例)及浸润性腺癌(38例)。比较不同病理亚型孤立性肺部分实性结节患者的CT征象。结果:常见的肺腺癌CT恶性形态学征象包括瘤-肺界面清晰、空泡征、分叶征、毛刺征、胸膜凹陷等,浸润性腺癌的瘤-肺界面清晰、空泡征、分叶征、毛刺征、胸膜凹陷等占比分别为89.47%、36.84%、76.32%、42.11%、98.74%,均高于浸润前病变及微浸润病变,差异有统计学意义(P <0.05)。结论:利用CT影像表现有助于对缺乏肺癌典型CT征象的患者进行病理亚型的初步判断,而早期对孤立性肺部分实性结节的性质进行正确评估,能使恶性结节被临床发现,让患者得到及时有效的治疗。

Objective To analyze the role of CT imaging manifestations of solitary lung nodules and pathological subtypes of lung adenocarcinoma in clinical diagnosis.Methods Retrospective analysis of CT imaging and pathological data of 74 patients with solitary lung partial solid nodules diagnosed and treated in The First People’s Hospital of Neijiang from July 2019 to June 2021.According to the new classification criteria of lung tumors,it was divided into pre-invasive lesions(15 cases),micro-invasive adenocarcinoma(21 cases) and invasive adenocarcinoma(38 cases).The CT signs of patients with solitary lung partial solid nodules of different pathological subtypes were compared.Results Common CT malignant morphological signs of lung adenocarcinoma include clear tumor-lung interface,vacuole sign,lobular sign,burr sign,pleural depression,etc.The proportions of invasive adenocarcinoma with clear tumor-lung interface,vacuole sign,lobular sign,burr sign,and pleural depression were 89.47%,36.84%,76.32%,42.11%,98.74%,respectively,and higher than the pre-invasive lesions and micro-invasive lesions,the difference was statistically significant(P< 0.05).Conclusion The use of CT images is helpful to make preliminary judgments of pathological subtypes of patients who lack the typical CT signs of lung cancer,the correct evaluation of the administration of some solid solitary lung nodules at an early stage can allow the malignant nodules to be found clinically and allow patients to receive timely and effective treatment.