摘要
目的探讨浸润腺癌(IAC)和微浸润腺癌(MIA)CT征象的鉴别诊断价值,提高术前诊断的准确性。方法回顾性分析本院135例经手术或穿刺病理证实的IAC和MIA的CT表现,对其CT表现特征进行分析,并构Logistic回归模型。结果135例患者中IAC 90例和MIA 45例。IAC肺窗结节最大直径(mm)、平均CT值(HU)、实占比(%)、分叶、毛刺、胸膜牵拉征的比例均高于MIA,差异有统计学意义(P<0.05)。而IAC和MIA的血管集束征、支气管充气征、空泡征等征象间差异无统计学意义(P>0.05)。Logistic回归分析显示,肺窗结节最大直径(mm)、实占比(%)是鉴别IAC和MIA的独立预测因子。肺窗最大径的AUC为0.806,阈值为9.01mm,敏感度和特异度分别为89%、58%。实性成分比例AUC为0.790,阈值为6%,敏感度和特异度分别为100%、69%。结论IAC和MIA肺窗结节最大直径(mm)、平均CT值(HU)、实占比(%)、分叶、毛刺、胸膜牵拉征具有重要的鉴别价值。肺窗结节最大直径(mm)、实占比(%)是预测IAC的独立预测因子。为术前诊断提供了重要的依据。
Objective To investigate the differential diagnosis value of CT features between invasive adenocarcinoma(IAC)and minimally invasive adenocarcinoma(MIA),and to improve the accuracy of preoperative diagnosis.Methods The CT manifestations of 135 cases of IAC and MIA confirmed by surgery or biopsy in our hospital were retrospectively analyzed,and the CT features were analyzed,and logistic regression model was constructed.Results Among the 135 patients,90 were IAC and 45 were MIA.The maximum diameter(mm),average CT value(HU),solid ratio(%),lobulation,burr,and pleural stretch sign of IAC lung window nodules were higher than those of MIA(P<0.05).However,there was no significant difference in the vascular bundle sign,air bronchus sign,or vacuolar sign between IAC and MIA(P>0.05).Logistic regression analysis showed that the maximum diameter(mm)of lung window nodules and the actual proportion(%)were independent predictors for differentiating IAC and MIA.The AUC of the largest diameter of the lung window was 0.806,the threshold was 9.01 mm,and the sensitivity and specificity were 89%and 58%,respectively.The solid component ratio AUC was 0.790,the threshold was 6%,and the sensitivity and specificity were 100%and 69%,respectively.Conclusion The maximum diameter(mm),mean CT value(HU),actual ratio(%),lobulation,burr,and pleural stretch sign of IAC and MIA lung window nodules have important differential value.Lung window nodules maximum diameter(mm)and actual ratio(%)are independent predictors of IAC,which provides an important basis for preoperative diagnosis.
作者
赵文
钱伟军
李立
王亚军
ZHAO Wen;QIAN Wei-jun;LI Li;WANG Ya-jun(Department of Imaging,Kaifeng Central Hospital,Kaifeng,Henan 475000,China)
出处
《临床肺科杂志》
2023年第4期517-522,共6页
Journal of Clinical Pulmonary Medicine
基金
开封市科技发展计划项目(No.2103046)。
关键词
浸润腺癌
微浸润腺癌
CT征象
鉴别诊断
invasive adenocarcinoma
minimally invasive adenocarcinoma
CT signs
differential diagnosis
