摘要
目的:探讨多层螺旋CT(MSCT)对周围型肺癌(PLC)的诊断价值及与组织病理学的相关性。方法:选取本院2018年6月-2019年10月收治的121例疑似PLC患者。所有患者均行MSCT检查,以病理结果为金标准,评估MSCT对PLC组织病理学类型的诊断符合率及诊断效能,分析PLC患者MSCT征象及其与组织病理学类型相关性。结果:121例疑似PLC患者中,101例经病理结果确诊为PLC,其中98例经MSCT检查提示为PLC,诊断符合率为97.03%(98/101)。MSCT对腺鳞癌与小细胞癌的诊断符合率均为100%;对腺癌的诊断符合率为97.83%(45/46);对鳞癌的诊断符合率为95.56%(43/45)。以病理结果作为金标准,MSCT诊断PLC的阳性预测值为97.96%,阴性预测值为78.26%,敏感度为95.05%,特异度为90.00%,诊断准确率为94.21%。MSCT对PLC诊断的ROC曲线下面积为0.714[95%CI(0.703,0.864)]。鳞癌深分叶征发生例数多于腺癌,而空泡征、磨玻璃征、空气支气管征、毛刺征、胸膜凹陷征及支气管血管集束征的发生例数均少于腺癌(P<0.05);鳞癌发生率与深分叶征呈正相关(P<0.05),腺癌发生率与空泡征、磨玻璃征、空气支气管征、毛刺征、胸膜凹陷征及支气管血管集束征均呈正相关(P<0.05)。结论:MSCT对PLC在疾病诊断、组织病理学类型诊断中具有较高的准确率,且深分叶征、空泡征、磨玻璃征、空气支气管征、毛刺征、胸膜凹陷征、支气管血管集束征与鳞癌、腺癌的鉴别具有一定相关性。
Objective:To investigate the diagnostic value of multislice spiral CT (MSCT) in peripheral lung cancer (PLC) and its correlation with histopathology.Method:A total of 121 suspected PLC patients admitted to our hospital from June 2018 to October 2019 were selected.All patients underwent MSCT examination,the diagnostic coincidence rate and diagnostic efficiency of MSCT for PLC histopathological types were evaluated using pathological results as the gold standard,and the MSCT signs of PLC patients and their correlation with histopathological types were analyzed.Result:Among the 121 suspected PLC patients,101 cases were diagnosed as PLC by pathological results,of which 98 cases were diagnosed as PLC by MSCT examination,and the diagnostic coincidence rate was 97.03% (98/101).The coincidence rate of MSCT in the diagnosis of adenosquamous carcinoma and small cell carcinoma was 100%.The coincidence rate of MSCT in the diagnosis of adenocarcinoma was 97.83% (45/46).The coincidence rate of MSCT in the diagnosis of squamous carcinoma was 95.56% (43/45).Using pathological results as the gold standard,the positive predictive value of MSCT for PLC diagnosis was 97.96%,the negative predictive value was 78.26%,the sensitivity was 95.05%,the specificity was 90.00%,and the diagnostic accuracy was 94.21%.The area under the ROC curve of MSCT for PLC diagnosis was 0.714[95%CI(0.703,0.864)].The incidence of squamous cell carcinoma with deep lobulation sign was more than that of adenocarcinoma,while the incidence of vacuole sign,ground glass sign,air bronchogram sign,spicule sign,pleural indentation sign and bronchovascular bundle sign were less than those of adenocarcinoma (P<0.05).The incidence of squamous cell carcinoma was positively correlated with deep lobulation sign (P<0.05),and the incidence of adenocarcinoma was positively correlated with vacuole sign,ground glass sign,air bronchogram sign,spicule sign,pleural indentation sign and bronchovascular bundle sign (P<0.05).Conclusion:MSCT has a high accuracy in the diagnosis of dis
作者
刘欣然
李志伟
LIU Xinran;LI Zhiwei(Jiamusi Traditional Chinese Medicine Hospital,Jiamusi 154002,China;不详)
出处
《中国医学创新》
CAS
2021年第5期67-71,共5页
Medical Innovation of China
关键词
周围型肺癌
多层螺旋CT
组织病理学
Peripheral lung cancer
Multi-slice spiral CT
Histopathology
