老年肺部磨玻璃影患者的影像学特征及术后病理分析

Postoperative pathological analysis of elderly pulmonary ground-glass opacity

目的分析老年肺部磨玻璃影(ground-glass opacity,GGO)患者的影像学特征及病理结果。方法对首都医科大学宣武医院2017年1月至2019年12月手术治疗的281例年龄大于60岁的老年GGO患者的影像学表现和术后病理结果进行回顾性研究。结果GGO最大径均值为(13.3±7.5)mm。Ⅰ型GGO病例97例(34.5%),Ⅱ型GGO病例119例(42.3%),Ⅲ型和Ⅳ型病例分别为51例(18.1%)和14例(5.0%)。术后病理报告:30例(10.7%)为良性病变,75例(26.7%)浸润前期病变,65例(23.1%)微浸润腺癌,111例(39.5%)浸润期肺癌。对GGO影像学特征与术后病理结果的相关性分析表明,依据GGO影像学特征所进行的GGO分型与术后病理结果存在显著相关性(r=0.365,P<0.01);GGO分型与肺癌病理亚型存在可能的关联(P<0.05,r=0.276),且与肺癌发生STAS(P<0.05,r=0.175)和胸膜浸润(P<0.01,r=0.236)存在显著相关性。结论老年患者的GGO影像学分型与术后肿瘤性质、肿瘤细胞的浸润程度密切相关。

Objective Analyze the imaging manifestations and pathological results of elderly patients with pulmonary ground-glass opacity(GGO).Methods The imaging findings and postoperative pathological findings of 281 GGO patients aged over 60 years who underwent surgical treatment in our hospital from January 2017 to December 2019 were retrospectively studied.Results The mean maximum diameter of GGO was(13.3±7.5)mm.There were 97 cases(34.5%)of GGO type I,119 cases(42.3%)of GGO typeⅡ,51 cases(18.1%)of GGO typeⅢand 14 cases(5.0%)of GGO type IV.The mean observation time was(13.5±23.3)months.In the postoperative pathological report,there were 30 cases(10.7%)of benign lesions,75 cases(26.7%)of preinvasive lesions,65 cases(23.1%)of minimally invasive adenocarcinoma(MIA),and 111 cases(39.5%)of invasive adenocarcinoma(IA).The correlation analysis of GGO imaging features and postoperative pathological results showed that there was a significant correlation between GGO classification based on GGO imaging features and postoperative pathological results(r=0.365,P<0.01).GGO classification was possibly correlated with pathological subtypes of lung cancer(P<0.05,r=0.276),and significantly correlated with STAS(P<0.05,r=0.175)and pleural infiltration(P<0.01,r=0.236).Conclusion The GGO imaging classification in elderly patients is more closely related to postoperative tumor properties and tumor invasive degree.