周围型肺癌的X线表现与组织学类型的对比研究

COMPARATIVE STUDY OF THE RELATIONSHIP BETWEEN RADIOGRAPHIC SIGNS AND HISTOLOGICAL TYPES OF PERIPHERAL PULMONARY CARCINOMAS

对378例周围型肺癌组织学类型与X线表现之间的关系进行了对照分析.结果表明,鳞癌空洞发生率高(18.4%),边缘大分叶状(39.5%),瘤周有长毛刺(34.7%).腺癌瘤体直径多<4cm(79%),边缘小分叶状(61.7%),瘤周毛刺短而细.状似毛刷(51.1%),胸膜凹陷征(13.9%),显著多于其他组织型;另有部分表现为弥漫结节或肺炎浸润状病灶.小细胞癌密度较高,边界清楚.大细胞癌呈边缘光滑的圆球形阴影,直径多为6cm以上(6/7).提示周围型肺癌的X线表现与组织学类型密切相关,X线检查有助于对组织学类型预测.

The relationship between radiographic signs and histological types of 378 patients with peripheral lung cancer was systematically studied. It was found that squamous cell carcinoma was most often characterized by large lobulated margins (39.5%) and longshaggy-surrounded tumors (34.7%),and had a much higher percentage of cavitations (18.4%) than other histological types. Adenocarcinoma presented in most cases as a single peripheral mass less than 4 cm in diameter (79%),with small lobulated margins (61.7%) and brush-like short and fine spiculates (51.1%) ,and was more frequently associated with pitting pleura (13.9%). Diffuse nodules or pneumonoid infiltrative shadows only appeared in adenocarcinoma. Small cell carcinoma showed a mass of high density and well-defined margins. Larger cell carcinoma most frequently presented as a round shadow larger than 6 cm in diameter (6/7) with sharp margins. This study re veals that radiographic signs of peripheral pulmonary carcinomas are closely correlated with the histological types and that X-ray examination gives aid to the disgnosis of histological types of the diseases.