摘要
目的探讨囊腔性肺腺癌的CT影像特征与肿瘤侵袭程度的关系。方法选取并分析经病理证实的28例囊腔性肺腺癌患者(微浸润腺癌7例,浸润性腺癌21例)的临床资料、病理类型和CT表现。根据病变CT密度不同分为Ⅰ、Ⅱ、Ⅲ、Ⅳ共四型。根据病灶浸润程度分微浸润与浸润性肺腺癌两组。对两组的CT征象采用T检验、卡方检验及Fisher确切概率法进行比较分析。结果28例患者中,微浸润和浸润性肺腺癌两组病灶的大小、非囊腔成分的大小、非囊腔成分的密度、整体形态、毛刺、胸膜牵拉凹陷影像学征象差异有统计学意义(P<0.05)。囊腔性肺腺癌的病理亚型是腺泡为主型浸润性腺癌占39.29%,乳头为主型的浸润性腺癌占25.00%、贴壁型的微浸润性腺癌占25.00%。囊腔性微浸润腺癌在Ⅱ、Ⅲ型病变中更常见;浸润性腺癌在Ⅲ、Ⅳ型病灶更常见。结论囊腔性腺癌组织学亚型以腺泡为主型、乳头为主型及贴壁为主型常见。薄层CT靶扫描及多平面重建有助于早期囊腔性腺癌术前准确诊断。非囊腔成分及囊腔形态等影像学表现有助于这类病变的定性诊断以及浸润程度的预测。
Objective To investigate the relationship between CT features oflung adenocarcinoma associated with cystic airspaces and tumor invasion.Methods The clinical data,pathological types and CT manifestations of 28 patients with lung adenocarcinoma associated with cystic airspaces(7 cases of microinvasive adenocarcinoma,21 cases of invasive adenocarcinoma)confirmed by pathology were analyzed retrospectively.According to the different CT density of the lesions,they were divided into four types I,II,III and IV.According to the degree of invasion,the patients were divided into two groups.T-test,chi square test and Fisher exact probability method were used to compare the CT signs of the two groups.Results In 28 cases,there were significant differences in the size of lesions,the size of non cystic components,the density of non cystic components,the overall shape,spiculation and pleural tag between the two groups(P<0.05).The pathological subtypes of lung adenocarcinoma associated with cystic airspaces were acinar adenocarcinoma(39.29%),papillary adenocarcinoma(25%)papillary adenocarcinoma(25%)and lepidic adenocarcinomae(25%).Microinvasive adenocarcinoma was more common in type II and type III lesions,and invasive adenocarcinoma was more common in type III and type IV lesions.Conclusion The histologic subtypes of lung adenocarcinoma associated with cystic airspaces are mainly acinar adenocarcinoma,papillary adenocarcinoma and lepidic adenocarcinomae.Thin slice CT target scanning and multiplanar reconstruction are helpful for the accurate preoperative diagnosis of early lung adenocarcinoma associated with cystic airspaces.The imaging findings of non cystic components and cystic morphology are helpful for the qualitative diagnosis and the prediction of invasion degree of these lesions.
作者
黎良山
刘传现
金晓霞
王省白
周冰
钱萍
LI Liangshan;LIU Chuanxian;JIN Xiaoxia;WANG Xingbai;ZHOU Bing;QIAN Ping(Department of Radiology, Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing 314002, P.R.China;Department of Pathology, Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital, Jiaxing,314002, P.R.China)
出处
《医学影像学杂志》
2021年第6期958-961,共4页
Journal of Medical Imaging
基金
浙江省嘉兴市科技计划项目(编号:2017AY33057)。
关键词
囊腔性肺腺癌
病理
体层摄影术
X线计算机
Lung adenocarcinoma associated with cystic airspaces
Pathology
Tomography,X-ray computed
