摘要
目的 用多因素回顾性研究的方法,探讨肺外恶性肿瘤患者肺内直径<3 cm的孤立性结节(ETM-SPN)定性诊断的可能性,并评价CT的鉴别诊断价值。方法 搜集经证实的直径<3 cm的ETM-SPN病例83例,通过对性别、年龄、吸烟史、肺内外病灶的平均时间间隔、肺内结节的CT形态学特征,以及肺外肿瘤病理类型与肺结节性质的关系等行多因素分析,探讨ETM-SPN定性诊断的相关因素。结果 83例肺部结节中孤立性转移瘤、原发性支气管肺癌、良性病灶分别为43、33和7例。平均年龄为(57.43±15.33)岁,男女之比为1.59:1。原发性支气管肺癌和孤立性转移瘤组的平均年龄和男女之比分别为(62.48±11.96)岁、1.20:1和(54.10±16.49)岁(t=3.34,P<0.05)、2.31:1(X2=0.0209,P>0.05)。各组吸烟率间,原发性支气管肺癌组(39.3％,11/17)与孤立性转移瘤组(35.9％,14/39)和非原发性肺癌组(33.3％,15/45)间差异均无显著意义(X2=0.640,P>0.05;X2=0.931,P>0.05)。原发性肺癌组和孤立性转移瘤组的肺内外肿瘤确诊的平均时间间隔分别为(65.62±13.45)个月和(22.83±4.19)个月,两组间差异有显著性意义(Wilcoxon秩和检验,U=2.796,P<0.01)。肺外肿瘤为鳞癌(10例)和腺癌(58例)者,其肺内病灶原发性肺癌、孤立性转移瘤比例分别为7:3和24:34,差异无显著性意义(X2=1.
Objective To determine the definitive diagnostic possibility of solitary pulmonary nodule in patients with a primary extrapulmonary neoplasm ( ETM-SPN) , and to further evaluate the differential diagnosis value of CT in ETM-SPN with a multivariate retrospective study. Methods Eighty-three patients with pathologically and clinically proved extrapulmonary malignant neoplasm and a solitary pulmonary nodule smaller than 3 cm in diameter were included in this study. The histologic characteristics of the nodules were correlated with those of the extrapulmonary neoplasm, and patient age, gender, smoking history, disease free interval between extrapulmonary malignancy and diagnosis of lung lesion. In all 83 cases, CT scans were reviewed to confirm the solitary nature, size, and nodular morphology of the lung lesion. Results Of all 83 cases, the mean age was (57. 43±15. 33) years. There were 51 males and 32 females, with the ratio of 1.59:1. The lesions included solitary metastasis in 43 cases, pulmonary malignant lesion in 33 , and benign lesion in 7. Between primary lung cancer group and solitary metastasis group, there was no significant differrence for gender ratio (1.20:1 vs 2, 31:1,X2=0. 0209, P >0. 05) , but there was significant differrence between the mean age [ (62. 48±11. 96) yrs vs (54. 10±16. 49) yrs, t = 3. 34, P < 0. 05 ]. In primary lung cancer and metastasis patient group, the percentage of patients who had smoking history was 39. 3% (11/17) and 35. 9% (14/39) , respectively. Patients with a primary lung cancer had no significant higher frequency of smoking history than those with a metastatic lesion (X2 =0. 640, P > 0. 05). Of 81 cases who had followed up. The mean time of diseases free interval between extrapulmoamy malignancy and pulmonary lesion was ( 39. 73±6.29) months ( range: 0-300 months, median, 20. 00 months) , those of primary lung cancer and metastatic group were (65. 62±13. 45 ) months and (22. 83± 4. 19) months, respectively, which had significant differrecnce between the two groups(
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第8期824-830,共7页
Chinese Journal of Radiology
关键词
肺外恶性肿瘤
肺内孤立性结节
CT
病理对照研究
Coin lesion, pulmonary
Neoplasm metastasis
Diagnosis, differential
Tomography, X-ray computed
Pathology
