表现为单纯磨玻璃密度结节的肺浸润性腺癌的影像学特征分析(1)

http://www.100md.com 2018年5月15日 《中国医学创新》 2018年第14期

     【摘要】 目的：探讨临床影像学上表现为单纯磨玻璃密度结节(pure ground-glass nodule，pGGN)的肺浸润性腺癌的影像学特征。方法：回顾性分析2012年1月-2017年12月于本院进行诊治，并接受胸部多排螺旋CT扫描检查，检查结果提示肺部伴有pGGN的46例患者的一般资料。按照肺癌组织学类型分为浸润性腺癌组(24例)和非浸润性腺癌组(22例)。比较两组病灶大小、密度、病灶周边及内部征象等影像学表现差异。结果：浸润性腺癌组pGGN大小、密度均显著高于非浸润性腺癌组，差异均有统计学意义(P<0.05)。两组pGGN病灶三維比率比较，差异无统计学意义(P>0.05)。浸润性腺癌组pGGN病灶分叶征、血管集束征与非浸润性腺癌组比较，差异均有统计学意义(字2=25.097、5.502，P<0.05)；浸润性腺癌组pGGN病灶毛刺征、空泡征、支气管充气征与非浸润性腺癌组比较，差异均无统计学意义(P>0.05)。结论：结合影像学上pGGN病灶大小、密度以及分叶征、血管集束征象等指标进行综合分析，有助于鉴别浸润性腺癌和AIS、MIA、AAH等非浸润性腺癌，有助于为疾病的早期诊断和患者个体化治疗提供依据。

    【关键词】 单纯磨玻璃密度结节； 肺浸润性腺癌； 64层螺旋CT

    Analysis of Imaging Features of Pulmonary Infiltrating Adenocarcinoma with Pure Ground-glass Nodule/WEN Kangyan，YE Wenqin，ZHANG Ziqin，et al.//Medical Innovation of China，2018，15(14)：087-090

    【Abstract】 Objective：To discuss the imaging features of invasive lung adenocarcinoma with pure ground-glass nodule(pGGN).Method：A total of 46 cases with pGGN received the multi-slice spiral CT scanning in our hospital from January 2012 to December 2017 were retrospective analysis，and they were divided into invasive lung adenocarcinoma group(24 cases)and non-invasive lung adenocarcinoma group(22 cases)，according to the histological types confirmed by the pathological results.The focal size，density，peripheral and internal signs were compared between the two groups.Result：The focal size and density in the invasive lung adenocarcinoma group were bigger than those in the non-invasive lung adenocarcinoma group(P<0.05).There were no statistical significance in the three-dimensional imaging ratio between the two groups(P>0.05).The lobulation sign and vessel convergence sign of pGGN in the invasive lung adenocarcinoma group more than those in the non-invasive lung adenocarcinoma group(字2=25.097，5.502，P<0.05)；there were no statistical significance in the spicule sign，vocule sign and air bronchogram of pGGN in the two groups(P>0.05).Conclusion：The comprehensive analysis on the size and density of pGGN and the lobulation sign ，vessel convergence sign and others of index are good to make the differential diagnosis of invasive lung adenocarcinoma and non-invasive lung adenocarcinoma(AIS，MIA，AAH)，which it provides the basis in the early diagnosis and individualized treatment.

    【Key words】 Pure ground-glass nodule； Invasive lung adenocarcinoma； 64-slice spiral CT scanning

    First-author’s address：Jiangmen Xinhui People’s Hospital，Jiangmen 529100，China

    doi：10.3969/j.issn.1674-4985.2018.14.021

    单纯磨玻璃密度结节(pure ground-glass nodule，pGGN)为肺部在影像学上表现为圆形或椭圆形形状、边界清晰的肺部局灶性高密度影，该病灶内无实性结节出现，且在高密度影中可见穿行的血管和支气管影[1]。有研究表明影像学上出现pGGN，提示出现早期肺癌的可能性较大，且持续存在的pGGN多为早期肺腺癌[2-3]。由于肺浸润性腺癌和非浸润性腺癌两者虽然在影像学上均具有pGGN病灶，但两者预后差异较大[4]。因此本研究探讨了临床影像学上表现为单纯磨玻璃密度结节的肺浸润性腺癌和非浸润性腺癌的影像学特征差异，现报道如下。(文康彦 叶文钦 张子钦)

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