CT定量分析鉴别肺亚实性肺腺癌不同病理亚型的价值

The Value of CT Quantitative Analysis in Differentiating Different Pathological Subtypes of Pulmonary Sub-solid Adenocarcinoma

目的:研究CT定量分析鉴别肺亚实性肺腺癌不同病理亚型的价值。方法:选取2020年1月-2022年6月海安市中医院肺亚实性肺腺癌患者57例,根据病理亚型分为浸润性肺腺癌(IAC)和非浸润性肺腺癌(n-IAC),比较IAC患者与n-IAC患者临床特征及CT定量分析参数,采用受试者工作特征(ROC)曲线分析CT定量参数对肺亚实性肺腺癌病理亚型的鉴别诊断价值。结果:IAC患者与n-IAC患者性别、年龄、结节部位、吸烟史、家族史比较,差异均无统计学意义(P>0.05);IAC患者结节直径、Ⅲ~Ⅳ期占比、低分化占比、淋巴结转移占比均大于n-IAC患者(P<0.05);IAC患者结节总体积、实性成分体积、三维平均CT值、实性成分体积比、结节总质量、实性成分质量、实性成分质量比均大于n-IAC患者(P<0.05);ROC曲线分析显示,实性成分体积比、实性成分质量比鉴别肺亚实性肺腺癌病理亚型的cut-off值分别为24.59%、28.74%,AUC分别为0.865、0.928,敏感度分别为84.85%、93.94%,特异度分别为87.50%、79.17%。结论:CT定量分析对肺亚实性肺腺癌病理亚型具有较高鉴别诊断价值。

Objective:To study the value of CT quantitative analysis in differentiating different pathological subtypes of pulmonary sub-solid adenocarcinoma.Method:From January 2020 to June 2022,57 patients with sub-solid lung adenocarcinoma in Hai'an Hospital of Traditional Chinese Medicine were selected and divided into invasive adenocarcinoma cancer(IAC)and non-invasive adenocarcinoma cancer(n-IAC)according to their pathological subtypes.The clinical characteristics and CT quantitative analysis parameters of IAC patients and n-IAC patients were compared.The value of CT quantitative parameters in the differential diagnosis of pathological subtypes of sub-solid lung adenocarcinoma was analyzed by using the receiver operating characteristic(ROC)curve.Result:There were no significant differences in gender,age,nodule location,smoking history and family history between IAC patients and n-IAC patients(P>0.05);the diameter of nodules,the proportion of stageⅢ-Ⅳ,the proportion of poorly differentiated and the proportion of lymph node metastasis in IAC patients were all larger than those in n-IAC patients(P<0.05);the total nodule volume,solid component volume,three-dimensional average CT value,solid component volume ratio,total nodule mass,solid component mass and solid component mass ratio of IAC patients were all greater than those of n-IAC patients(P<0.05);ROC analysis showed that the cut-off value of solid component volume ratio and solid component mass ratio in differentiating pathological subtypes of lung sub-solid lung adenocarcinoma were 24.59%,28.74%,AUC were 0.865,0.928,sensitivity were 84.85%,93.94%,specificity were 87.50%,79.17%.Conclusion:CT quantitative analysis has a high value in differential diagnosis of pathological subtypes of pulmonary sub-solid adenocarcinoma.