Analysis of histopathologic subtypes and CT characteristics of lung adenocarcinomas presenting as pure ground-glass nodule around 1-3 cm in maximal diameter
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摘要: 目的 探讨最大径1~3 cm的纯磨玻璃密度影(pGGO)肺腺癌的病理分类和CT征象特点。 方法 回顾性分析温州医科大学附属台州医院2013年10月-2016年12月间CT表现为纯磨玻璃密度结节(pGGN),且最大径为1~3 cm的192例(共192个病灶)经手术病理证实为肺腺癌患者的CT、病理和临床资料。分为3组,包括浸润前病变31个(含不典型腺瘤样增生4个、原位腺癌27个)、微浸润腺癌(MIA)71个、浸润性腺癌(IPA)90个。应用SPSS 22.0统计学软件分析不同病理类型间患者的年龄、性别以及病变的大小、密度、位置、形态、空泡征、空气支气管征、胸膜凹陷征、血管改变、病变边缘、瘤-肺界面、均匀度之间的差异。 结果 各病理亚型间性别、部位、瘤-肺界面及形状的差异均无统计学意义。浸润前病变、MIA和IPA病变大小、密度以及患者年龄差异具有统计学意义。3组病变出现血管改变、空泡征、空气支气管征、胸膜凹陷征的差异具有统计学意义;病变的浸润程度越高,均匀度越低;IPA相比于浸润前病变及MIA,毛刺或毛刺+分叶征象更多见。鉴别浸润前病变和浸润性病变的密度界值为-549.35 Hu,敏感度为74.50%,特异度为71.00%。 结论 最大径1~3 cm pGGN肺腺癌的患者年龄、病灶大小、密度、边缘、血管改变、均匀度、空泡征、空气支气管征及胸膜凹陷征对病理分类有一定预测价值。
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关键词:
- 肺肿瘤 /
- 腺癌 /
- 体层摄影术,X线计算机
Abstract: Objective To evaluate the correlations between CT features and histopathologic subtypes of lung adenocarcinomas presenting as pure ground-glass nodules (pGGN) around 1-3 cm in maximal diameter. Methods CT appearances, pathology and clinical data of 192 patients (192 lesions). To be divided three classes, including 31 preinvasive lesions 4 atypical adenomatous hyperplasia, 27 adenocarcinoma in situ, 71 minimally invasive adenocarcinoma (MIA) and 90 invasive pulmonary adenocarcinoma (IPA) who underwent curative resection of lung adenocarcinomas presenting as 1 ≤ pGGN ≤ 3 cm in diameter from October, 2013 to December, 2016 were retrospectively analyzed in our hospital. Via SPSS 22.0 statistics software, age and gender of patients, lesion size, density, lesion location, shape, presence of bubble-like sign, air bronchogram, pleural tag, vessel changes, margin, tumor-lung interface and uniformity were compared among histopathologic subtypes. Results There were no significant differences among histopathologic subtypes in terms of gender of patients, lesion location, tumor-lung interface, and shape. There were significant differences among lesion preinvasion, MIA and IPA in terms of age, lesion size and density. There were statistically significant differences among histopathologic subtypes in terms of vessel changes, presence of bubble-like sign, air bronchogram and pleural tag. With the increasing degree of invasiveness, the homogeneous uniformity of lesions tend to lessen; Compared with preinvasive lesions and MIA, IPA was more inclined to present as speculated or speculated plus lobulated. There were statistically significant differences among histopathologic subtypes in terms of uniformity and margin. The optimal cutoff value of lesion density for differentiating preinvasive lesions from invasive lesions was -549.35 Hu (sensitivity, 74.50%; specificity, 71.00%). Conclusion Age of patients, lesion size, density, margin, vessel changes, uniformity, presence of bubble-like sign, air bronchogram and pleural tag may indicate the invasiveness of lung adenocarcinoma presenting as pGGNs of 1 to 3 cm in diameter.-
Key words:
- Lung neoplasms /
- Adenocarcinoma /
- Tomography, X-ray computed
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