同时多原发肺腺癌的CT征象与病理分化程度的关系
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摘要
目的探讨同时多原发肺腺癌患者的CT征象与病理分化程度的关系。方法回顾性分析37例同时多原发肺腺癌患者的临床资料,共计82个病灶,其中高分化腺癌21个,中分化腺癌38个,低分化腺癌23个。收集并分析患者的CT影像及病理检查资料。结果高分化病灶中毛刺征、胸膜凹陷征的比例分别为57.14%、38.10%,低于中分化和低分化病灶的84.21%、86.84%和91.30%、91.30%,差异均有统计学意义(P﹤0.05);高分化、中分化、低分化病灶中毛刺征、胸膜凹陷征的比例比较,差异均有统计学意义(P﹤0.05);高分化、中分化、低分化病灶中密度为非实性、实性的比例比较,差异均有统计学意义(P﹤0.05);低分化病灶中密度为实性的比例为60.87%,高于中分化、高分化病灶的31.58%、23.81%,差异均有统计学意义(P﹤0.05)。结论不同分化程度的同时多原发肺腺癌患者的病灶密度、毛刺征及胸膜凹陷征存比例在差异,值得进一步研究。
Objective To investigate the relationship between CT findings and pathological differentiation of synchronous multiple primary lung adenocarcinoma.Method The clinical profiles of 37 patients with synchronous multiple primary lung adenocarcinoma were analyzed retrospectively,among them,82 lesions were identified,including 21 well-differentiated adenocarcinoma,38 moderately differentiated adenocarcinoma and 23 poorly differentiated adenocarcinoma,the CT images and pathological data of these patients were collected and analyzed.Result The percentage of spicule sign and pleural indentation sign in well-differentiated lesions were 57.14% and 38.10%,which were significantly lower than those of moderately differentiated and poorly differentiated lesions at 84.21%,86.84% and 91.30%,91.30%,respectively,the differences were statistically significant(P<0.05).The ratio of spicule sign and pleural indentation sign in welldifferentiated lesions,moderately differentiated lesions and poorly differentiated lesions was significantly different(P<0.05).The ratio of solid and non-solid density in lesions of low-,intermediate-and high-grade differentiation showed statistically significant differences(P<0.05);the ratio of solid density in poorly differentiated lesions was 60.87%,which was significantly higher than that of moderately-and well-differentiated lesions at 31.58% and 23.81%,respectively,the difference was of statistical significance(P<0.05).Conclusion The ratio of lesion density,spicule sign and pleural indentation sign in synchronous multiple primary lung adenocarcinoma of varying differentiation are inconsistent,and further study is warranted.
Objective To investigate the relationship between CT findings and pathological differentiation of synchronous multiple primary lung adenocarcinoma.Method The clinical profiles of 37 patients with synchronous multiple primary lung adenocarcinoma were analyzed retrospectively,among them,82 lesions were identified,including 21 well-differentiated adenocarcinoma,38 moderately differentiated adenocarcinoma and 23 poorly differentiated adenocarcinoma,the CT images and pathological data of these patients were collected and analyzed.Result The percentage of spicule sign and pleural indentation sign in well-differentiated lesions were 57.14% and 38.10%,which were significantly lower than those of moderately differentiated and poorly differentiated lesions at 84.21%,86.84% and 91.30%,91.30%,respectively,the differences were statistically significant(P<0.05).The ratio of spicule sign and pleural indentation sign in welldifferentiated lesions,moderately differentiated lesions and poorly differentiated lesions was significantly different(P<0.05).The ratio of solid and non-solid density in lesions of low-,intermediate-and high-grade differentiation showed statistically significant differences(P<0.05);the ratio of solid density in poorly differentiated lesions was 60.87%,which was significantly higher than that of moderately-and well-differentiated lesions at 31.58% and 23.81%,respectively,the difference was of statistical significance(P<0.05).Conclusion The ratio of lesion density,spicule sign and pleural indentation sign in synchronous multiple primary lung adenocarcinoma of varying differentiation are inconsistent,and further study is warranted.
引文
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[15]张孝先,陈学军,王立峰,等.肺腺癌CT征象与表皮生长因子受体基因突变的相关性研究[J].中华放射学杂志,2016,50(6):416-420.
[16]沈春林,周建军,刘月军,等.磨玻璃密度结节肺腺癌MDCT表现[J].现代肿瘤医学,2017,25(1):108-111.
[17]褚志慧,牛放,牛玉军.两种肺CT磨玻璃结节的特点与肺腺癌病理分型的关系[J].解放军医学院学报,2016,18(12):1267-1269.
[18]肖旻,徐秋贞.磨玻璃结节肺腺癌CT征象与病理分类及EGFR、ALK基因突变相关性的研究进展[J].东南大学学报(医学版),2017,36(3):500-503.
[19]李月月,罗学毛,张鑫,等.磨玻璃结节样多灶性肺腺癌CT征象与病理对照[J].中国医学影像技术,2018,34(1):60-63.
[20]徐佳佳,王红,赵年,等.GGN样早期肺腺癌CT形态学特征的Fisher判别[J].现代肿瘤医学,2018,26(1):109-113.
[21]陈相猛,郝以秀,李荣岗,等.T1a期肺腺癌CT征象与病理对照研究[J].临床放射学杂志,2016,35(10):1502-1506.
[2]石颜慧,仓顺东,栗超跃,等.肺腺癌脑膜转移患者的预后分析[J].肿瘤,2017,37(4):385-390.
[3]李欣,章智荣,傅毅立,等.不同组织亚型不同基因型同时性多原发肺癌(附1例病例报道)[J].中国肺癌杂志,2017,17(12):857-860.
[4]罗扬,徐兵河,王爽,等.6例原发肺腺癌乳腺转移的临床特征分析[J].癌症进展,2016,14(7):699-702.
[5]Martini N,Melamed MR.Multiple primary lung cancers[J].J Thorac Cardiovasc Surg,1975,70(4):606-612.
[6]曹捍波,王梅,范艳芬,等.平均CT值测量对≤1 cm同时多原发肺腺癌亚型分型的诊断价值[J].浙江医学,2018,17(4):354-357.
[7]Ko JP,Suh J,Ibidapo O,et al.Lung adenocarcinoma:correlation of quantitative CT findings with pathologic findings[J].Radiology,2016,280(3):931-939.
[8]Liu Y,Kim J,Qu F,et al.CT features associated with epidermal growth factor receptor mutation status in patients with lung adenocarcinoma[J].Radiology,2016,280(1):271-280.
[9]彭岳,王晖,谢厚耐,等.同时性多原发肺腺癌的外科治疗及预后[J].中国肺癌杂志,2017,20(2):107-113.
[10]徐晓莉,宋伟,隋昕,等.原发性肺肉瘤样癌的CT表现与病理特点[J].中国医学科学院学报,2016,38(1):93-98.
[11]Yanagawa M,Johkoh T,Noguchi M,et al.Radiological prediction of tumor invasiveness of lung adenocarcinoma on thin-section CT[J].Medicine(Baltimore),2017,96(11):e6331.
[12]朱海旭,孙宏亮,杨天智,等.周围型空洞性肺腺癌多层螺旋CT比较研究[J].中日友好医院学报,2017,31(5):283-286.
[13]谭国光,欧艳荘,何瑞成.多层螺旋CT与胸部X线诊断早期肺癌的应用对比分析[J].中国医药科学,2017,7(3):126-129.
[14]左玉强,李玉然,康伟峰,等.伴有薄壁空腔形成的周围型肺腺癌的CT表现[J].临床肺科杂志,2016,21(7):1303-1305.
[15]张孝先,陈学军,王立峰,等.肺腺癌CT征象与表皮生长因子受体基因突变的相关性研究[J].中华放射学杂志,2016,50(6):416-420.
[16]沈春林,周建军,刘月军,等.磨玻璃密度结节肺腺癌MDCT表现[J].现代肿瘤医学,2017,25(1):108-111.
[17]褚志慧,牛放,牛玉军.两种肺CT磨玻璃结节的特点与肺腺癌病理分型的关系[J].解放军医学院学报,2016,18(12):1267-1269.
[18]肖旻,徐秋贞.磨玻璃结节肺腺癌CT征象与病理分类及EGFR、ALK基因突变相关性的研究进展[J].东南大学学报(医学版),2017,36(3):500-503.
[19]李月月,罗学毛,张鑫,等.磨玻璃结节样多灶性肺腺癌CT征象与病理对照[J].中国医学影像技术,2018,34(1):60-63.
[20]徐佳佳,王红,赵年,等.GGN样早期肺腺癌CT形态学特征的Fisher判别[J].现代肿瘤医学,2018,26(1):109-113.
[21]陈相猛,郝以秀,李荣岗,等.T1a期肺腺癌CT征象与病理对照研究[J].临床放射学杂志,2016,35(10):1502-1506.