摘要
目的探讨CT影像联合肿瘤相关抗体对早期肺腺癌患者型别的鉴别诊断价值。方法回顾性分析Ⅰ期肺腺癌的106例患者的临床资料。根据病理类型分为附壁生长为主浸润腺癌(LPA)组与浸润生长型腺癌(IPA)组。采用双盲法记录病灶的位置、形态、大小、边缘、病灶-肺界面、邻近结构改变、支气管充气征等,测量结节的CT值、结节大小、实性成分大小,分析比较两组患者肿瘤相关抗体及影像学征象的相关性。结果 LPA组与IPA组患者纯磨玻璃密度结节(p GGN)与混合磨玻璃密度结节(mGGN)分布、结节形态比较,差异有统计学意义(χ^2分别=31.54、18.89,P均<0.05);LPA组患者的结节CT值、结节实性成分/结节面积比、结节实性成分/结节体积、分叶、毛刺、血管聚集、支气管截断、胸膜凹陷、抗体阳性出现率均明显低于IPA组(t分别=4.73、4.39、4.01,χ^2分别=8.72、8.32、26.05、5.78、21.63、6.56,P均<0.05),但病灶-肺界面清楚出现率明显高于IPA组(χ^2=24.19,P<0.05)。106例患者中抗体阳性57例,阳性率53.77%;抗体阳性患者的分叶、胸膜凹陷出现率明显高于抗体阴性组(χ^2分别=12.87、6.79,P均<0.05)。结论 pGGN与mGGN主要CT征象、病灶-肺界面清楚、结节CT值较低、结节实性成分/结节面积比、结节实性成分/结节体积比较低,有助于LPA诊断。肿瘤相关抗体仅与分叶、胸膜凹陷出现率相关,对于LPA与IPA鉴别诊断无帮助。
Objective To explore the value of CT imaging combined with tumor-related antibodies in the differential diagnosis of early lung cancer patients. Methods The clinical data of 106 patients with stageⅠlung cancer was analyzed retrospectively.According to the pathological type,they were divided into LPA group and IPA group.The location,shape,size,edge,lesion-lung interface,adjacent structural changes,bronchoinflatable sign were recorded by double blind method.The CT value,nodular size and solid component size of nodules were measured by post-processing workstation.The correlation between tumor-related antibodies and imaging signs was analyzed. Results There were significant differences in the distribution of pGGN and mGGN and the morphology of nodules between LPA group and IPA group(χ^2=31.54,18.89,P<0.05).The CT value,ratio of nodular solid component/nodular area,ratio of nodular solid component/nodular volume,lobulation,burr,vascular aggregation,bronchus truncation,pleura depression and antibody positive ratio in LPA group were significantly lower than those in IPA group(t=4.73,4.39,4.01,χ^2=8.72,8.32,26.05,5.78,21.63,6.56,P<0.05),but the rate of the clear of lesion-lung interface was significantly higher than that in IPA group(χ^2=24.19,P<0.05).Totally 57 of 106 patients were positive for antibody,the positive rate was 53.77%.The occurrence rate of lobulation and pleura depression in antibody positive group was significantly higher than that in antibody negative group(χ^2=12.87,6.79,P<0.05). Conclusion The main CT signs of pGGN and mGGN,the clear focus-lung interface,the lower CT value of nodules,the ratio of solid components/area of nodules,and the ratio of solid components/volume of nodules are helpful to the diagnosis of LPA.Tumor-related antibodies are only related to lobulation and pleural depression,which is not helpful for differential diagnosis of LPA and IPA.
作者
戚洲卿
QI Zhouqing(Department of Radiology,Zhuji People’s Hospital,Shaoxing 311800,China)
出处
《全科医学临床与教育》
2019年第8期693-696,共4页
Clinical Education of General Practice
关键词
影像
肿瘤相关抗体
肺腺癌
鉴别
imaging
tumor-associated antibody
lung adenocarcinoma
differentiation
