肺鳞癌误诊为肺脓肿的CT影像学表现

CT Imaging Findings of Lung Squamous Cell Carcinoma Misdiagnosed as Lung Abscess

目的 分析肺鳞癌误诊为肺脓肿的计算机断层扫描(CT)影像学特征,以提高对肺鳞癌的认识及诊断正确率。方法 选择2017年12月至2022年12月于河南科技大学第一附属医院收治的112例曾经误诊为肺脓肿的肺鳞癌患者和同期确诊为肺脓肿的80例患者作为研究对象,前者为肺鳞癌组,后者为肺脓肿组,均接受CT平扫和增强扫描。比较两组患者的临床表现、病程和CT下病变主体及周围病灶的影像学特征。结果 肺鳞癌组患者病程长于肺脓肿组(P<0.05),肺鳞癌组CT表现为空洞伴液平患者占比低于肺脓肿组(P<0.05),空洞壁厚>15 mm患者占比高于肺脓肿组(P<0.05);肺鳞癌组CT病灶周围形态表现为边缘模糊患者占比低于肺脓肿组(P<0.05)。抗感染后,肺鳞癌组病灶缩小的患者占比低于肺脓肿组(P<0.05),病灶无变化的患者占比高于肺脓肿组(P<0.05)。两组临床表现差异无统计学意义(P>0.05)。结论 相比于肺脓肿,肺鳞癌患者CT下较少出现空洞伴液平、病灶边缘模糊特征,多表现为空洞壁厚>15 mm、抗感染后病灶无变化,这些CT影像学特征对于肺鳞癌和肺脓肿的鉴别诊断具有重要意义。

Objective To analyze the computed tomography(CT)imaging characteristics of lung squamous cell carcinoma misdiagnosed as lung abscess so as to improve the cognition and correct diagnosis rate of lung squamous cell carcinoma.Methods A total of 112 patients with lung squamous cell carcinoma misdiagnosed as lung abscesses and 80 patients with lung abscess in the hospital were enrolled as lung squamous cell carcinoma group and lung abscess group between December 2017 and December 2022,respectively.All underwent CT plain scan and enhancement scan.The clinical manifestations,course of disease,and CT imaging characteristics of lesions and surrounding lesions were compared between the two groups.Results The course of disease in lung squamous cell carcinoma group was longer than that in lung abscess group(P<0.05),proportion of cases with cavities and liquid level was lower than that in lung abscess group(P<0.05),and proportion of cases with cavity wall thickness>15 mm was higher than that in lung abscess group(P<0.05).The proportion of cases with blurred edges of surrounding lesions in lung squamous cell carcinoma group was lower than that in lung abscess group(P<0.05).After anti-infection,the proportion of cases with reduced lesions in lung squamous cell carcinoma group was lower than that in lung abscess group(P<0.05),while proportion of cases with unchanged lesions was higher than that in lung abscess group(P<0.05).There was no significant difference in clinical manifestations between the two groups(P>0.05).Conclusion Compared with lung abscess patients,there are fewer CT characteristics such as cavities combined with liquid level and blurred lesion edge in lung squamous cell carcinoma patients,while there are more characteristics such as cavity wall thickness over 15 mm and unchanged lesions after anti-infection.These CT imaging characteristics are of great significance in the differential diagnosis of lung squamous cell carcinoma and lung abscess.