多层螺旋CT检查对周围型肺癌的诊断价值

Diagnosis value of multislice spiral CT in peripheral lung cancer

目的 探讨多层螺旋CT(MSCT)检查对周围型肺癌的诊断价值。方法 收集88例疑似周围型肺癌患者的病历资料,所有患者均接受MSCT检查和病理学检查。以病理结果为金标准,分析MSCT检查对周围型肺癌的诊断价值;比较不同组织学类型周围型肺癌患者的MSCT征象;分析周围型肺癌患者MSCT征象与腺癌、鳞状细胞癌的相关性。结果 病理学检查诊断周围型肺癌72例,MSCT检查诊断周围型肺癌66例。MSCT诊断周围型肺癌的准确度、灵敏度及特异度分别为86.36%(76/88)、87.50%(63/72)、81.25%(13/16)。MSCT检查结果显示,腺癌28例,鳞状细胞癌26例,腺鳞癌10例,小细胞癌2例。不同组织学类型周围型肺癌患者MSCT征象中空泡征、磨玻璃征、深分叶征、空气支气管征、毛刺征、胸膜凹陷征、支气管血管集束征比较,差异均有统计学意义(P﹤0.01)。Spearman相关分析结果显示,深分叶征与鳞状细胞癌呈负相关(P﹤0.01),支气管血管集束征与腺癌呈负相关(P﹤0.01),空泡征、磨玻璃征、空气支气管征、毛刺征、胸膜凹陷征均与腺癌呈正相关(P﹤0.05)。结论 MSCT征象与周围型肺癌的组织病理学具有相关性,具有极高的临床价值,值得推广。

Objective To explore the diagnosis value of multislice spiral CT(MSCT)in peripheral lung cancer.Method Medical records of 88 patients with suspected peripheral lung cancer were collected,and all patients underwent MSCT and pathological examination.The diagnostic value of MSCT in peripheral lung cancer was analyzed by using pathological results as the gold standard;the MSCT signs of patients with different histological types of peripheral lung cancer were analyzed;the correlation of MSCT signs in peripheral lung cancer patients with adenocarcinoma and squa-mous cell carcinoma were analyzed.Result A total of 72 cases of peripheral lung cancer were diagnosed by pathology,66 cases of peripheral lung cancer by MSCT.The diagnostic accuracy,sensitivity and specificity of MSCT in the diagno-sis of peripheral lung cancer were 86.36%(76/88),87.50%(63/72)and 81.25%(13/16),respectively.A total of 28 cases of adenocarcinoma,26 cases of squamous cell carcinoma,10 cases of adenocsquamous and 2 cases of small cell carcino-ma were detected by MSCT.There were statistically significant differences in vacuole sign,ground glass sign,deep lobu-lar sign,air bronchial sign,burr sign,pleural sag sign and bronchial vascular bunching sign in MSCT signs of patients with different histological types of peripheral lung cancer(P<0.01).The results of Spearman correlation analysis showed that the deep lobular sign was negatively correlated with squamous cell carcinoma(P<0.01),the bronchial vascular bunch-ing sign was negatively correlated with adenocarcinoma(P<0.01),and the vacuole sign,ground glass sign,air bronchial sign,burr sign,pleural sag sign were positively correlated with adenocarcinoma(P<0.05).Conclusion MSCT signs are correlated with histopathology of peripheral lung cancer,which has very high clinical value,and is worthy of promotion.