亚厘米磨玻璃结节CT特点与临床病理的关系

Correlation between CT Characteristics and Clinicopathology of Subcm Grinding Glass Nodules

目的 探究亚厘米磨玻璃结节CT影像特点评估病变性质,并分析其与临床病理的关系。方法以2015年8月至2021年2月80例亚厘米磨玻璃结节患者为研究对象,根据手术病理结果将其分为良性组、浸润前组及腺癌组,比较三组的CT影像特点,采用多元logistics回归分析CT影像特点与腺癌发生的关系,并采用ROC曲线分析分析CT影像特点对良性结节与非良性结节及浸润性结节与腺癌的鉴别价值。结果 良性组的结节小于浸润前组及腺癌组,胸膜“凹陷”征、边缘形态“分叶”征、“毛刺”征、“空气支气管”征、血管异常改变、瘤肺界面不清晰发生率低于浸润前组及腺癌组(P<0.05);腺癌组的结节大于浸润前组,胸膜“凹陷”征、边缘形态“分叶”征、“毛刺”征、“空气支气管”征、血管异常改变、瘤肺界面不清晰发生率高于浸润前组(P<0.05);结节大小、边缘形态鉴别良性结节、非良性结节的AUC大于0.75;结节大小、胸膜“凹陷”征鉴别浸润前结节及腺癌的AUC大于0.75;结节≥7.59mm、胸膜“凹陷”征、血管异常改变是影响腺癌发生的危险因素(P<0.05)。结论结节大小、边缘形态、胸膜“凹陷”征等CT影像特点可用于鉴别良恶性亚厘米磨玻璃结节,且结节≥7.59mm、胸膜“凹陷”征、血管异常改变是影响腺癌发生的危险因素。

Objective To explore the evaluation of lesions natures by CT imaging characteristics of sub-centimeter ground-glass nodules(GGN), and to analyze their relationship with clinicopathology. Methods A total of 80 patients with sub-centimeter GGN from August 2015 to February 2021 were enrolled as the research objects. According to surgical pathological results, they were divided into benign group, preinvasion group and adenocarcinoma group. CT imaging characteristics among the three groups were compared. The relationship between CT imaging characteristics and adenocarcinoma was analyzed by multivariate Logistics regression analysis. The value of CT imaging characteristics in distinguishing benign nodules from non-benign nodules, and invasive nodules from adenocarcinoma was analyzed by ROC curves. Results The nodules in benign group were smaller than those in pre-invasion group and adenocarcinoma group, and incidence of pleural indentation, lobulation sign, spiculation, air bronchography sign, abnormal vessel changes and unclear lung tumor interface was lower than that in pre-invasion group and adenocarcinoma group(P<0.05). The nodules in adenocarcinoma group were larger than those in pre-invasion group, and incidence of pleural indentation, lobulation sign,spiculation, air bronchography sign, abnormal vessel changes and unclear lung tumor interface was higher than that in pre-invasion group(P<0.05). AUC values of nodule size and edge morphology in distinguishing benign and non-benign nodules were greater than 0.75. AUC values of nodule size and pleural indentation in distinguishing pre-invasion nodules and adenocarcinoma were greater than 0.75. The nodule not shorter than 7.59mm, pleural indentation and abnormal vessels changes were risk factors of adenocarcinoma(P<0.05). Conclusion CT imaging features such as nodule size,edge morphology and pleural indentation can be applied to distinguish benign and malignant subcentimeter GGN. The nodule not shorter than 7.59mm, pleural indentation and abnormal vessels changes are risk factors of adenocarcinoma.