肺磨玻璃结节病理学分级与高分辨率CT征象的相关性分析
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摘要
目的探讨肺磨玻璃结节病理学分级与高分辨率CT征象的相关性。方法选取病理诊断为肺部磨玻璃结节患者127例,分析患者的CT表现与病理性分级的相关性。结果非典型腺瘤样增生(AAH)、完全沿肺泡间隔贴壁样生长的原位腺癌(AIS)、微浸润腺癌(MIA)、浸润性腺癌(IA)组患者年龄比较,差异无统计学意义(P> 0. 05); AAH、AIS、MIA组性别比较,差异无统计学意义(P> 0. 05),IA组与AAH、AIS组性别相比较,差异有统计学意义(P <0. 05)。IA组与MIA组毛刺征发生率差异无统计学意义(P> 0. 05),但均显著高于AIS组、AAH组(P <0. 05),且AIS组毛刺征发生率显著高于AAH组(P <0. 05)。AAH、AIS、MIA组分叶征发生率比较,差异均无统计学意义(P> 0. 05),IA组分叶征发生率显著高于AAH、AIS与MIA组(P <0. 05)。AAH、AIS、MIA组空泡征发生率比较差异无统计学意义(P> 0. 05),IA组空泡征发生率显著高于AAH、AIS和MIA组(P <0. 05)。AIS、MIA、IA组支气管充气征发生率显著高于AAH组(P <0. 05),IA组显著高于AIS组(P <0. 05),MIA组与IA组比较差异无统计学意义(P> 0. 05)。IA组胸膜凹陷征发生率显著高于AAH、AIS、MIA组(P <0. 05),MIA组胸膜凹陷征发生率显著高于AAH组(P <0. 05),MIA组与AIS组胸膜凹陷征发生率比较差异无统计学意义(P> 0. 05)。结论毛刺征、分叶征、空泡征、支气管充气征、胸膜凹陷征是鉴别肺磨玻璃结节病理学分级的重要依据,对磨玻璃结节的CT影像学特征进行分析有利于病理学分级的鉴别。
Objective To explore the correlation between pathological grading of groundglass nodules and high resolution CT signs. Methods A total of 127 patients diagnosed as groundglass nodules were selected,and correlation between CT manifestation and pathological grading was analyzed. Results There was no significant difference in age among patients with atypical adenomatoid hyperplasia( AAH),adherent adenocarcinoma in situ( AIS) growing completely along alveolar septum,microinvasive adenocarcinoma( MIA) and invasive adenocarcinoma( IA)( P > 0. 05). There was no significant difference in gender among AAH group,AIS group and MIA group( P > 0. 05),but there were significant differences between IA group and AAH group,AIS group( P < 0. 05). There was no significant difference in the incidence rate of burr sign between IA group and MIA group( P >0. 05),but both were significantly higher than AIS group and AAH group( P < 0. 05),and the incidence rate of burr sign in AIS group was significantly higher than that in AAH group( P < 0. 05).There was no significant difference in the incidence rate of leaf sign among AAH group,AIS group and MIA group( P > 0. 05),but the incidence rate of leaf sign in IA group was significantly higher than that in AAH group,AIS group and MIA group( P < 0. 05). There was no significant difference in the incidence rate of vacuole sign among AAH group,AIS group and MIA group( P > 0. 05),but the incidence rate of vacuole sign in IA group was significantly higher than that in AAHgroup,AIS group and MIA group( P < 0. 05). The incidence rate of bronchial inflation sign in AIS group,MIA group and IA group was significantly higher than that in AAH group( P < 0. 05),and which in IA group was significantly higher than that in AIS group( P < 0. 05),but there was no significant difference between MIA group and IA group( P > 0. 05). The incidence rate of pleural indentation in IA group was significantly higher than that in AAH group,AIS group and MIA group( P < 0. 05),and which in MIA group was significantly higher than that in AAH group( P < 0. 05),but there was no significant difference between MIA group and AIS group( P > 0. 05). Conclusion Burr sign,lobulation sign,vacuole sign,bronchial pneumatic sign and pleural indentation sign are the important basis for differentiating pathological grading of ground-glass nodules. The analysis of CT imaging features of ground-glass nodules is helpful for differentiating pathological grading.
Objective To explore the correlation between pathological grading of groundglass nodules and high resolution CT signs. Methods A total of 127 patients diagnosed as groundglass nodules were selected,and correlation between CT manifestation and pathological grading was analyzed. Results There was no significant difference in age among patients with atypical adenomatoid hyperplasia( AAH),adherent adenocarcinoma in situ( AIS) growing completely along alveolar septum,microinvasive adenocarcinoma( MIA) and invasive adenocarcinoma( IA)( P > 0. 05). There was no significant difference in gender among AAH group,AIS group and MIA group( P > 0. 05),but there were significant differences between IA group and AAH group,AIS group( P < 0. 05). There was no significant difference in the incidence rate of burr sign between IA group and MIA group( P >0. 05),but both were significantly higher than AIS group and AAH group( P < 0. 05),and the incidence rate of burr sign in AIS group was significantly higher than that in AAH group( P < 0. 05).There was no significant difference in the incidence rate of leaf sign among AAH group,AIS group and MIA group( P > 0. 05),but the incidence rate of leaf sign in IA group was significantly higher than that in AAH group,AIS group and MIA group( P < 0. 05). There was no significant difference in the incidence rate of vacuole sign among AAH group,AIS group and MIA group( P > 0. 05),but the incidence rate of vacuole sign in IA group was significantly higher than that in AAHgroup,AIS group and MIA group( P < 0. 05). The incidence rate of bronchial inflation sign in AIS group,MIA group and IA group was significantly higher than that in AAH group( P < 0. 05),and which in IA group was significantly higher than that in AIS group( P < 0. 05),but there was no significant difference between MIA group and IA group( P > 0. 05). The incidence rate of pleural indentation in IA group was significantly higher than that in AAH group,AIS group and MIA group( P < 0. 05),and which in MIA group was significantly higher than that in AAH group( P < 0. 05),but there was no significant difference between MIA group and AIS group( P > 0. 05). Conclusion Burr sign,lobulation sign,vacuole sign,bronchial pneumatic sign and pleural indentation sign are the important basis for differentiating pathological grading of ground-glass nodules. The analysis of CT imaging features of ground-glass nodules is helpful for differentiating pathological grading.
引文
[1]张典智,阎青显,侯文章.肺单发磨玻璃结节影像诊断与处理策略[J].医学理论与实践,2012,25(23):2954-2955.
[2]葛虓俊,高丰,李铭,等.磨玻璃结节中实性成分对肺腺癌术前CT诊断的价值[J].中华医学杂志,2014,94(13):1010-1013.
[3]邹勤,范丽,李琼,等.肺磨玻璃密度结节MDCT定量与病理分型相关性的研究[J].实用放射学杂志,2016,32(11):1681-1684,1695.
[4]金鑫,赵绍宏,高洁,等.纯磨玻璃密度肺腺癌病理分类及影像学表现特点分析[J].中华放射学杂志,2014,48(4):283-287.
[5]郭金栋,孙希文.高分辨率CT肺纯磨玻璃结节影像与肺腺癌病理新分类的相关性[J].中国临床医学,2016,23(4):449-453.
[6]杜鹏,曹爱红.胸部HRCT联合多期增强扫描对肺内单发磨玻璃结节的诊断价值[J].影像研究与医学应用,2017,1(9):100-101.
[7] Travis W D,Brambilla E,Nicholson A G,et al. The 2015World Health Organization Classification of lung tumor:impact of genetic,clinical and radiologic advances since the2004 classification[J]. J Thorac Oncol,2015,10(9):1243-1260.
[8]彭德昌,龚洪翰,余克涵,等.肺部局灶性磨玻璃密度结节MSCT诊断[J].实用放射学杂志,2012,28(1):29-32,41.
[9]朱晓龙,邹殿俊,李传贵,等.肺部磨玻璃结节的MSCT的诊断价值[J].河北北方学院学报:自然科学版,2016,32(4):16-17.
[10]吕英刚,暴军辉,刘贵延,等.多层螺旋CT多种重建后处理技术对肺内磨玻璃结节的早期定性诊断研究[J].心肺血管病杂志,2015,34(11):853-857.
[11]曹忠良.肺局限性磨玻璃样病灶的外科处理进展[J].辽宁医学杂志,2012,26(5):249-251.
[12] Patrick A H,Valentina C R,Patrik R,et al. Variability of semiautomated lung nodule volumetry ultralow-dose CT:comparison with nodule volumetry on standard-dose CT[J]. J Digital Imag,2010,23(1):8-17.
[13]王智君,唐艳隆.不同性质肺混合性磨玻璃结节CT特征分析[J].西南国防医药,2017,27(10):1088-1090.
[14]何慧,孙鹏飞,曹向荣,等.肺局灶性磨玻璃密度结节的多层螺旋CT诊断[J].中国医学影像学杂志,2014,22(2):121-123,126.
[15]朱万荣,万拓君.肺部混合性磨玻璃结节样腺癌的多层螺旋CT影像学特征分析[J].广西医科大学学报,2017,34(3):383-386.
[16]陈楠,谢坪,付凯.空泡征对早期肺癌的诊断价值[J].医学影像学杂志,2002,12(1):73-74.
[17]左玉强,孟庆春,田云霞,等.纯磨玻璃密度浸润前病变与浸润性肺腺癌的临床及CT鉴别[J].重庆医学,2017,46(13):1782-1785.
[18]张东军,周新宇,张佳.肺部局灶性磨玻璃密度结节的临床表现及其MSCT相关征象分析[J].海南医学,2015,26(14):2083-2085.
[2]葛虓俊,高丰,李铭,等.磨玻璃结节中实性成分对肺腺癌术前CT诊断的价值[J].中华医学杂志,2014,94(13):1010-1013.
[3]邹勤,范丽,李琼,等.肺磨玻璃密度结节MDCT定量与病理分型相关性的研究[J].实用放射学杂志,2016,32(11):1681-1684,1695.
[4]金鑫,赵绍宏,高洁,等.纯磨玻璃密度肺腺癌病理分类及影像学表现特点分析[J].中华放射学杂志,2014,48(4):283-287.
[5]郭金栋,孙希文.高分辨率CT肺纯磨玻璃结节影像与肺腺癌病理新分类的相关性[J].中国临床医学,2016,23(4):449-453.
[6]杜鹏,曹爱红.胸部HRCT联合多期增强扫描对肺内单发磨玻璃结节的诊断价值[J].影像研究与医学应用,2017,1(9):100-101.
[7] Travis W D,Brambilla E,Nicholson A G,et al. The 2015World Health Organization Classification of lung tumor:impact of genetic,clinical and radiologic advances since the2004 classification[J]. J Thorac Oncol,2015,10(9):1243-1260.
[8]彭德昌,龚洪翰,余克涵,等.肺部局灶性磨玻璃密度结节MSCT诊断[J].实用放射学杂志,2012,28(1):29-32,41.
[9]朱晓龙,邹殿俊,李传贵,等.肺部磨玻璃结节的MSCT的诊断价值[J].河北北方学院学报:自然科学版,2016,32(4):16-17.
[10]吕英刚,暴军辉,刘贵延,等.多层螺旋CT多种重建后处理技术对肺内磨玻璃结节的早期定性诊断研究[J].心肺血管病杂志,2015,34(11):853-857.
[11]曹忠良.肺局限性磨玻璃样病灶的外科处理进展[J].辽宁医学杂志,2012,26(5):249-251.
[12] Patrick A H,Valentina C R,Patrik R,et al. Variability of semiautomated lung nodule volumetry ultralow-dose CT:comparison with nodule volumetry on standard-dose CT[J]. J Digital Imag,2010,23(1):8-17.
[13]王智君,唐艳隆.不同性质肺混合性磨玻璃结节CT特征分析[J].西南国防医药,2017,27(10):1088-1090.
[14]何慧,孙鹏飞,曹向荣,等.肺局灶性磨玻璃密度结节的多层螺旋CT诊断[J].中国医学影像学杂志,2014,22(2):121-123,126.
[15]朱万荣,万拓君.肺部混合性磨玻璃结节样腺癌的多层螺旋CT影像学特征分析[J].广西医科大学学报,2017,34(3):383-386.
[16]陈楠,谢坪,付凯.空泡征对早期肺癌的诊断价值[J].医学影像学杂志,2002,12(1):73-74.
[17]左玉强,孟庆春,田云霞,等.纯磨玻璃密度浸润前病变与浸润性肺腺癌的临床及CT鉴别[J].重庆医学,2017,46(13):1782-1785.
[18]张东军,周新宇,张佳.肺部局灶性磨玻璃密度结节的临床表现及其MSCT相关征象分析[J].海南医学,2015,26(14):2083-2085.