混合磨玻璃结节实性成分的CT定量参数对肺腺癌组织分化的预测价值

The Predictive Value of CT Quantitative Parameters of Solid Component of Mixed Ground Glass Nodules in Differentiation of Lung Adenocarcinoma

探讨肺部混合磨玻璃结节(mGGN)实性成分的三维CT定量参数预测浸润性非黏液腺癌(IAC)组织分化程度的价值。回顾性分析99例术后病理证实为IAC患者的临床及影像资料。依据国际肺癌研究学会病理新分级系统分为:高分化IAC(53例)、中分化IAC(31例)、低分化IAC(15例)。观察实性成分的三维CT定量参数与IAC组织分化程度之间的相关性。结果显示:实性成分体积、体积占比、平均CT值、平均直径在不同组织分化程度之间的差异均具有统计学意义(P<0.001)。多重比较结果显示,低分化IAC的实性成分体积、体积占比、平均CT值、平均直径均大于中高分化IAC;而中分化与高分化IAC之间仅体积占比有统计学意义。将高分化IAC与中分化IAC合并纳入A组,低分化IAC纳入B组,预测低分化IAC的ROC曲线结果显示实性成分体积、体积占比、平均CT值、平均直径的cut-off值分别为341.5 mm~3、52.9%、-116.5 HU、9.65 mm。总之,mGGN实性成分的三维CT定量参数对IAC的组织分化程度有较高的预测价值,对选择诊治方案和判断患者预后有较大的指导意义。

To explore the predictive value of three-dimensional CT quantitative parameters of solid component of mixed ground glass nodules in differentiation of lung invasive adenocarcinoma(IAC).The clinical and imaging data of 99 patients with IAC confirmed by pathology after operation was retrospectively analyzed.According to the grading system of the International Association for the Study of Lung Cancer Pathology Committee,highly differentiated IAC(53 cases),moderately differentiated IAC(31 cases),poorly differentiated IAC(15 cases).The correlation between three-dimensional CT quantitative parameters of solid component and the degree of differentiation in IAC was observed.The results showed that the volume,volume percentage,mean CT value and average diameter of solid component had statistically significant differences among three groups(P<0.001).The results of multiple comparison showed that the volume,volume percentage,mean CT value and average diameter of the solid component in poorly differentiated IAC were higher than those in other two groups.However,the volume percentage between moderately differentiated IAC and highly differentiated IAC was statistically significant.The highly differentiated IAC and the moderately differentiated IAC were included in group A,and the poorly differentiated IAC was included in group B.The ROC curve for predicting poorly differentiated IAC showed that the cut-off values of the volume,volume percentage,mean CT value and average diameter of solid component were 341.5 mm 3,52.9%,-116.5 HU,9.65 mm.The three-dimensional CT quantitative parameters of the solid component of mGGN have a high predictive value for the degree of differentiation,the guiding significance for making a diagnosis and giving treatment and judging the prognosis are obtained.