基础医学与临床 ›› 2019, Vol. 39 ›› Issue (8): 1131-1135.

• 研究论文 • 上一篇    下一篇

3 cm以下周围型非小细胞肺癌薄层CT征象分析

徐岩1,练伟2,吴晓华1,杨正汉1   

  1. 1. 首都医科大学附属北京友谊医院
    2. 盐城市第三人民医院CT室
  • 收稿日期:2019-06-14 修回日期:2019-06-25 出版日期:2019-08-05 发布日期:2019-07-16
  • 通讯作者: 徐岩 E-mail:doctorxy08@126.com
  • 基金资助:
    北京市自然科学基金资助项目(面上项目)

Analysis of thin-section CT signs of peripheral non-small cell lung cancer below 3 cm

  • Received:2019-06-14 Revised:2019-06-25 Online:2019-08-05 Published:2019-07-16
  • Contact: Yan Xu E-mail:doctorxy08@126.com

摘要: 目的 探讨3 cm以下周围型非小细胞肺癌实性结节的薄层CT征象,以提高其病理组织学类型预测的准确率。方法 回顾性分析经手术病理证实的218例3 cm以下的周围型非小细胞肺癌实性结节病例(其中鳞状细胞癌76例、腺癌142例);记录患者的临床病理情况(包括患者的性别、年龄、肿瘤的病理类型)和薄层CT征象(包括结节部位、直径、形态、边缘特征和强化情况)。结果 周围型鳞状细胞癌(p-SqCC)和腺癌实性结节在男女患病率的差异明显(P<0.05);腺癌实性结节在支气管充气征、空泡征、毛刺征、胸膜凹陷征上较p-SqCC显著性高,而二者在结节形状、分叶征、空洞征、支气管血管集束征上差异无统计学意义。结论 支气管充气征、空泡征、胸膜凹陷征、短毛刺征同时出现时,对腺癌实性结节诊断的特异性达89.7%,灶状坏死对p-SqCC诊断具有特异性。薄层CT征象有助于周围型鳞状细胞癌与腺癌实性结节的鉴别诊断。

关键词: 周围型肺鳞状细胞癌, 腺癌, 体层摄影术,X线计算机, 临床病理特征

Abstract: Objective To investigate the thin-section CT signs of peripheral non-small cell lung cancer below 3 cm with solid nodule, and to improve the accuracy of its histopathological type prediction. Methods We retrospectively analyzed the 218 cases of solid nodules 3cm or less with non-small cell lung cancer (including 76 cases of squamous cell carcinoma, 142 cases of adenocarcinoma) confirmed by surgical pathology. The patient's clinical pathology included gender, age, and pathological type of tumor, as well as location, diameter, morphology, marginal features, and enhancement of nodules. The measurement data were expressed as x ± s. The count data were expressed as a percentage. Chi-square test was used to compare differences between groups of signs. Results There was a statistically significant difference in the prevalence of p-SqCC and adenocarcinoma solid nodules between men and women. The p-SqCC and adenocarcinoma solid nodules at the focal necrosis, air bronchogram sign, vacuolar sign, burr sign, pleura indentation, and enhancement pattern were statistically significant (P<0.05). There was no statistical difference in nodule shape, lobulated sign, hole sign, and bronchial vascular bundle sign. Conclusion The specificity of diagnosis for adenocarcinoma solid nodules is 89.7% based on air bronchogram sign, bronchus encapsulated air sign, pleura indentation, and short burr sign. Focal necrosis is specific for p-SqCC diagnosis. Thin-section CT signs have certain value in the differential diagnosis of peripheral adenocarcinoma solid nodules and p-SqCC.

Key words: Peripheral lung Squamous cell Carcinoma(p-SqCC), Aenocarcinoma, Tomography,Computed, clinicopathologic characteristics