高分辨CT对肺微浸润型腺癌的诊断价值

Diagnostic value of high-resolution computed tomography for pulmonary micro-invasive adenocarcinoma

目的分析高分辨CT(HRCT)对肺微浸润型腺癌(MIA)的诊断价值。方法抽取2020年1月至2022年12月于济宁市第三人民医院经病理诊断的MIA患者76例为MIA组,另抽取同期于医院经病理诊断的肺原位腺癌(AIS)患者76例为AIS组。分析两组患者的HRCT影像学特征,采用Logistic回归分析两组的HRCT特征分布,采用受试者工作特征曲线分析HRCT经线和密度参数对MIA的诊断价值。结果AIS组与MIA组的HRCT影像学特征比较,径线、密度、分叶征、毛刺征、空泡征、胸膜牵拉征差异有统计学意义(P<0.05),形态、位置、空气支气管差异未见统计学意义(P>0.05)。Logistic回归分析结果显示,径线和密度是预测MIA的独立危险因素(OR=4.34、4.19,P均<0.05);受试者工作特征曲线分析结果显示,HRCT经线、密度值单独检测与联合检测诊断MIA的曲线下面积分别为0.812、0.709、0.885(P<0.05)。结论HRCT影像学特征对诊断MIA有一定的效能,且径线与密度两项参数联合检测能够更准确诊断MIA。

Objective To analyze the diagnostic value of high-resolution computed tomography(HRCT)for pulmonary micro-invasive adenocarcinoma(MIA).Methods A total of 76 patients with MIA confirmed by pathology in Jining Third People’s Hospital from January 2020 to December 2022 were selected as MAI group,while other 76 patients with pulmonary adenocarcinoma in situ(AIS)diagnosed by pathology during the same period were selected as AIS group.The HRCT imaging characteristics of the two groups were analyzed.The distribution of HRCT characteristics of the two groups were analyzed by logistic regression analysis.The diagnostic value of diameter line(an average of major diameter and vertical minor diameter)and density of HRCT imaging for MIA were analyzed by receiver operating characteristic curves.Results The differences in HRCT imaging characteristics(diameter line,density,lobular sign,spicule sign,vacuole sign,pleural traction sign)between AIS group and MIA group were statistically significant(P<0.05),while the difference in morphology,sites and air bronchogram sign was not statistically significant(P<0.05).The results of logistic regression analysis showed that diameter line and density were independent risk factors for predicting MIA(OR=4.34,4.19;all P<0.05).Results of receiver operating characteristic curve showed that area under the curve of diameter line alone,density alone and combination of them in diagnosis of MIA were 0.812,0.709 and 0.885,respectively(P<0.05).Conclusion The imaging characteristics of HRCT have certain diagnostic efficiency for MIA.The combined detection of diameter line and density can diagnose MIA more accurately.