孤立性肺结节良恶性危险因素研究进展
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摘要
孤立性肺结节的检出率随着CT影像技术的进步,有着显著的上升,并且当代人们对健康的意识也越来越强,而早期结节的性质由于多种因素的影响较难鉴别,因此,肺结节的良恶性如果能够在初期得到全面的评估,将具有积极的意义。本文对良恶性孤立性肺结节患者的年龄、性别、血清肿瘤标志物、CT影像学特点、吸烟史、既往肿瘤史等相关因素的价值做一综述。
Progress in computed tomography(CT) imaging technology has led to a significant increase in the detection rate of solitary pulmonary nodules.Although health awareness is improving,the early signs of pulmonary nodules are becoming more difficult to identify due to the effects of many factors.If pulmonary nodules can be fully evaluated as benign or malignant at the early stage,this would have a positive effect.This article summarizes and reviews the diagnostic value of related factors such as age,gender,serum tumor markers,CT imaging features,smoking history,and previous tumor history in patients with benign and malignant solitary pulmonary nodules.
Progress in computed tomography(CT) imaging technology has led to a significant increase in the detection rate of solitary pulmonary nodules.Although health awareness is improving,the early signs of pulmonary nodules are becoming more difficult to identify due to the effects of many factors.If pulmonary nodules can be fully evaluated as benign or malignant at the early stage,this would have a positive effect.This article summarizes and reviews the diagnostic value of related factors such as age,gender,serum tumor markers,CT imaging features,smoking history,and previous tumor history in patients with benign and malignant solitary pulmonary nodules.
引文
[1]SIM Y T,POON F W.Imaging of solitary pulmonary nodule-a clinical review[J].Quant Imaging Med Surg,2013,3(6):316-326.DOI:10.3978/j.issn.2223-4292.2013.12.08.
[2]王俊,刘彦国.肺内小结节的诊治现状、问题和方向[J].中华胸心血管外科杂志,2012,28(7):385-386,389.DOI:10.3760/cma.j.issn.1001-4497.2012.07.001.WANG J,LIU Y G.Current status of diagnosis and treatment,problems and directions of small pulmonary nodules[J].Chinese Journal of Thoracic and Cardiovascular Surgery,2012,28(7):385-386,389.DOI:10.3760/cma.j.issn.1001-4497.2012.07.001.
[3]SWENSEN S J,SILVERSTEIN M D,ILSTRUP D M,et al.The probability of malignancy in solitary pulmonary nodules.Application to small radiologically indeterminate nodules[J].Arch Intern Med,1997,157(8):849-855.DOI:10.1001/archin te.1997.00440290031002.
[4]YANG L,ZHANG Q,BAI L,et al.Assessment of the cancer risk factors of solitary pulmonary nodules[J].Oncotarget,2017,8(17):29318-29327.DOI:10.18632/oncotarget.16426.
[5]MCWILLIAMS A,TAMMEMAGI M C,MAYO J R,et al.Probability of cancer in pulmonary nodules detected on first screening CT[J].N Engl J Med,2013,369(10):910-919.DOI:10.1056/NEJMoa1214726.
[6]TORRE L A,BRAY F,SIEGEL R L,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.DOI:10.3322/caac.21262.
[7]IARC Working Group on the Evaluation of Carcinogenic Risks to Humans.Personal habits and indoor combustions.Volume 100 E.A review of human carcinogens[J].IARC Monogr Eval Carcinog Risks Hum,2012,100(Pt E):1-538.
[8]BAI C,CHOI C M,CHU C M,et al.Evaluation of pulmonary nodules:clinical practice consensus guidelines for Asia[J].Chest,2016,150(4):877-893.DOI:10.1016/j.chest.2016.02.650.
[9]GóMEZ-SáEZ N,HERNáNDEZ-AGUADO I,VILAR J,et al.Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study[J].Eur Radiol,2015,25(12):3518-3527.DOI:10.1007/s00330-015-3775-3.
[10]MITCHELL P S,PARKIN R K,KROH E M,et al.Circulating micro RNAs as stable blood-based markers for cancer detection[J].Proc Natl Acad Sci U S A,2008,105(30):10513-10518.DOI:10.1073/pnas.0804549105.
[11]GENG Q,FAN T,ZHANG B,et al.Five micro RNAs in plasma as novel biomarkers for screening of early-stage non-small cell lung cancer[J].Respir Res,2014,15(1):149.DOI:10.1186/s12931-014-0149-3.
[12]LI X,ZHANG Q,JIN X,et al.Combining serum mi RNAs,CEA,and CYFRA21-1 with imaging and clinical features to distinguish benign and malignant pulmonary nodules:a pilot study:Xianfeng Li et al.:Combining biomarker,imaging,and clinical features to distinguish pulmonary nodules[J].World J Surg Oncol,2017,15(1):107.DOI:10.1186/s12957-017-1171-y.
[13]刘慧,李永怀,桂淑玉.肺癌患者血清肿瘤标记物检测的临床意义及预后评估[J].临床肺科杂志,2014,19(12):2219-2223.DOI:10.3969/j.issn.1009-6663.2014.012.030.LIU H,LI Y H,GUI S Y.Clinical significance and prognostic evaluation of serum tumor markers in patients with lung cancer[J].Journal of Clinical Pulmonary Medicine,2014,19(12):2219-2223.DOI:10.3969/j.issn.1009-6663.2014.012.030.
[14]BELLIER J,PERENTES J Y,ABDELNOUR-BERCHTOLD E,et al.A plea for thoracoscopic resection of solitary pulmonary nodule in cancer patients[J].Surg Endosc,2017,31(11):4705-4710.DOI:10.1007/s00464-017-5543-8.
[15]SHI C Z,ZHAO Q,LUO L P,et al.Size of solitary pulmonary nodule was the risk factor of malignancy[J].J Thorac Dis,2014,6(6):668-676.DOI:10.3978/j.issn.2072-1439.2014.06.22.
[16]张用,毕建平,皮国良,等.国际肺癌研究协会第八版国际肺癌TNM分期修订稿解读[J].肿瘤防治研究,2016,43(4):313-318.DOI:10.3971/j.issn.1000-8578.2016.04.016.ZHANG Y,BI J P,PI G L,et al.An interpretation of revised version of international association for study of lung cancer for forthcoming 8th edition of TNM classification for lung cancer[J].Cancer Research on Prevention and Treatment,2016,43(4):313-318.DOI:10.3971/j.issn.1000-8578.2016.04.016.
[17]HATTORI A,MATSUNAGA T,TAKAMOCHI K,et al.Importance of ground glass opacity component in clinical stage IA radiologic invasive lung cancer[J].Ann Thorac Surg,2017,104(1):313-320.DOI:10.1016/j.athoracsur.2017.01.076.
[18]WINER-MURAM H T,JENNINGS S G,TARVER R D,et al.Volumetric growth rate of stageⅠlung cancer prior to treatment:serial CT scanning[J].Radiology,2002,223(3):798-805.DOI:10.1148/radiol.2233011026.
[19]AHN M I,GLEESON T G,CHAN I H,et al.Perifissural nodules seen at CT screening for lung cancer[J].Radiology,2010,254(3):949-956.DOI:10.1148/radiol.09090031.
[20]龚拥军,包宏伟.CT像上支气管充气征的再分析[J].实用医学影像杂志,2009,10(1):21-23,57.DOI:10.3969/j.issn.1009-6817.2009.01.008.GONG Y J,BAO H W.Further analysis of air bronchograms on CT images[J].Journal of Practical Medical Imaging,2009,10(1):21-23,57.DOI:10.3969/j.issn.1009-6817.2009.01.008.
[21]于瀚宇,尹志伊,徐峰,等.青岛地区肺团块或肺结节病人的病因调查及分析[J].世界最新医学信息文摘,2016,16(5):151-152.DOI:10.3936/j.issn.1671-3141.2016.05.121.YU H Y,YI Z Y,XU F,et al.The investigation and analysis of etiological factor about pulmonary mass or pulmonary nodules in Qingdao area[J].The World's Latest Medical Information Abstracts,2016,16(5):151-152.DOI:10.3936/j.issn.1671-3141.2016.05.121.
[22]LEE H J,KIM Y T,KANG C H,et al.Epidermal growth factor receptor mutation in lung adenocarcinomas:relationship with CT characteristics and histologic subtypes[J].Radiology,2013,268(1):254-264.DOI:10.1148/radiol.13112553.
[23]DAI J,SHI J,SOODEEN-LALLOO A K,et al.Air bronchogram:a potential indicator of epidermal growth factor receptor mutation in pulmonary subsolid nodules[J].Lung Cancer,2016,98:22-28.DOI:10.1016/j.lungcan.2016.05.009.
[24]LEE H Y,LEE K S.Ground-glass opacity nodules:h i s t o p a t h o l o g y,i m a g i n g e v a l u a t i o n,a n d c l i n i c a l implications[J].J Thorac Imaging,2011,26(2):106-118.DOI:10.1097/RTI.0b013e3181fbaa64.
[25]王自立,黄胜,栗兵,等.肺局灶性磨玻璃密度结节(f GGO)的多层螺旋CT(MSCT)特征与病灶良恶性的相关性分析[J].中国CT和MRI杂志,2016,14(2):49-51.DOI:10.3969/j.issn.1672-5131.2016.02.017.WANG Z L,HUANG S,LI B,et al.Correlation analysis of multi-slice spiral CT(MSCT)features of focal ground-glass opacity(f GGO)and the property of the pulmonary lesions[J].Chinese Journal of CT and MRI,2016,14(2):49-51.DOI:10.3969/j.issn.1672-5131.2016.02.017.
[26]AOKI T,HANAMIYA M,URAMOTO H,et al.Adenocarcinomas with predominant ground-glass opacity:correlation of morphology and molecular biomarkers[J].Radiology,2012,264(2):590-596.DOI:10.1148/radiol.12111337.
[27]LEE H Y,CHOI Y L,LEE K S,et al.Pure ground-glass opacity neoplastic lung nodules:histopathology,imaging,and management[J].AJR Am J Roentgenol,2014,202(3):W224-233.DOI:10.2214/AJR.13.11819.
[28]BERRY M F,GAO R,KUNDER C A,et al.Presence of even a small ground glass component in lung adenocarcinoma predicts better survival[J].Clin Lung Cancer,2017.DOI:10.1016/j.cllc.2017.06.020.
[29]MA J,YANG Y L,WANG Y,et al.Relationship between computed tomography morphology and prognosis of patients with stageⅠnon-small cell lung cancer[J].Onco Targets Ther,2017,10:2249-2256.DOI:10.2147/OTT.S114960.
[30]么娜,刘巍.肺内恶性孤立性小结节的CT征象特征分析与诊断[J].临床肺科杂志,2016,21(8):1493-1495.DOI:10.3969/j.issn.1009-6663.2016.08.039.YAO N,LIU W.Analysis and diagnosis of CT syndrome characteristics of solitary pulmonary nodules[J].Journal of Clinical Pulmonary Medicine,2016,21(8):1493-1495.DOI:10.3969/j.issn.1009-6663.2016.08.039.
[31]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.DOI:10.13437/j.cnki.jcr.2016.10.014.CHEN X M,HAO Y X,LI R G,et al.T1a stage lung adenocarcinomas:CT features and pathological findings[J].Journal of Clinical Radiology,2016,35(10):1502-1506.DOI:10.13437/j.cnki.jcr.2016.10.014.
[32]LEE S M,PARK C M,GOO J M,et al.Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as groundglass nodules:differentiation by using CT features[J].R a d i o l o g y,2 0 1 3,2 6 8(1):2 6 5-2 7 3.D O I:10.1148/radiol.13120949.
[33]ERASMUS J J,CONNOLLY J E,MCADAMS H P,et al.Solitary pulmonary nodules:PartⅠ.Morphologic evaluation for differentiation of benign and malignant lesions[J].Radiographics,2000,20(1):43-58.DOI:10.1148/radiogra phics.20.1.g00ja0343.
[34]HERDER G J,VAN TINTEREN H,GOLDING R P,et al.Clinical prediction model to characterize pulmonary nodules:validation and added value of 18F-fluorodeoxyglucose positron emission tomography[J].Chest,2005,128(4):2490-2496.DOI:10.1378/chest.128.4.2490.
[35]崔军胜.分叶征在孤立性肺结节CT诊断中的价值[J].中国现代药物应用,2012,6(19):37-38.DOI:10.14164/j.cnki.cn11-5581/r.2012.19.025.CUI J S.The value of lobulation syndrome in the diagnosis of solitary pulmonary nodule[J].Chinese Journal of Modern Drug Application,2012,6(19):37-38.DOI:10.14164/j.cnki.cn11-5581/r.2012.19.025.
[36]张福康,马军,陈境弟,等.肺炎性假瘤的CT表现与误诊分析[J].影像诊断与介入放射学,2011,20(3):186-189.DOI:10.3969/issn.1005-8001.2011.03.007.ZHANG F K,MA J,CHEN J D,et al.Diagnostic CT features of pulmonary inflammatory pseudotumor[J].Diagnosis Imaging and Interventional Radiology,2011,20(3):186-189.DOI:10.3969/issn.1005-8001.2011.03.007.
[37]蒋彬,孙天宇,邓波,等.孤立性肺结节良、恶性危险因素分析和外科诊治[J].中国胸心血管外科临床杂志,2016,23(7):702-705.DOI:10.7507/1007-4848.20160168.JIANG B,SUN T Y,DENG B,et al.Character of solitary pulmonary nodules:analysis of risk factors and surgical treatment[J].Chinese Journal of Clinical Thoracic and Cardiovascular Surgery,2016,23(7):702-705.DOI:10.7507/1007-4848.20160168.
[38]肖刚.胸膜凹陷征在周围型肺癌与结核球鉴别诊断中的价值[J].内蒙古中医药,2011,30(21):102.DOI:10.3969/j.issn.1006-0979.2011.21.100.XIAO G.The value of pleural indentation in differential diagnosis of peripheral lung cancer and tuberculoma[J].Inner Mongol Journal of Traditional Chinese Medicine,2011,30(21):102.DOI:10.3969/j.issn.1006-0979.2011.21.100.
[39]CHU Z G,SHENG B,LIU M Q,et al.Differential diagnosis of solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography[J].Clinics(Sao Paulo),2016,71(10):555-561.DOI:10.6061/clinics/2016(10)01.
[40]MURRMANN G B,VAN VOLLENHOVEN F H,MOODLEY L.Approach to a solid solitary pulmonary nodule in two different settings-"Common is common,rare is rare"[J].J Thorac Dis,2014,6(3):237-248.DOI:10.3978/j.issn.2072-1439.2013.11.13.
[41]OST D,FEIN A.Management strategies for the solitary pulmonary nodule[J].Curr Opin Pulm Med,2004,10(4):272-278.DOI:10.1097/01.mcp.0000130322.11513.c8.
[42]王秋萍,金晨望,邓蕾,等.探讨肺结节内钙化密度与钙化征象的临床意义[J].医学影像学杂志,2014,24(10):1729-1733.WANG Q P,JIN C W,DENG L,et al.Clinical value of calcification density and signs in the diagnosis of lung nodules[J].Journal of Medical Imaging,2014,24(10):1729-1733.
[43]MAHONEY M C,SHIPLEY R T,CORCORAN H L,et al.CT demonstration of calcification in carcinoma of the lung[J].AJR Am J Roentgenol,1990,154(2):255-258.DOI:10.2214/ajr.154.2.2153329.
[44]GIOVINO G A,MIRZA S A,SAMET J M,et al.Tobacco use in 3 billion individuals from 16 countries:an analysis of nationally representative cross-sectional household surveys[J].Lancet,2012,380(9842):668-679.DOI:10.1016/S0140-6736(12)61085-X.
[45]PARKIN D M,BRAY F,FERLAY J,et al.Global cancer statistics,2002[J].CA Cancer J Clin,2005,55(2):74-108.DOI:10.3322/canjclin.55.2.74.
[46]CHEN K Y,HSIAO C F,CHANG G C,et al.Estrogen receptor gene polymorphisms and lung adenocarcinoma risk in never-smoking women[J].J Thorac Oncol,2015,10(10):1413-1420.DOI:10.1097/JTO.0000000000000646.
[47]佘晖,方振剑,陈方榕,等.孤立性肺结节患者临床特征分析[J].中国呼吸与危重监护杂志,2015,14(4):376-379.DOI:10.7507/1671-6205.2015093.SHE H,FANG Z J,CHEN F R,et al.The relationship between clinical characteristics and pathology findings of solitary pulmonary nodules[J].Chinese Journal of Respiratory and Critical Care Medicine,2015,14(4):376-379.DOI:10.7507/1671-6205.2015093.
[48]RENA O,DAVOLI F,Boldorini R,et al.The solitary pulmonary nodule in patients with previous cancer history:results of surgical treatment[J].Eur J Surg Oncol,2013,39(11):1248-1253.DOI:10.1016/j.ejso.2013.08.014.
[49]MIDTHUN D E,JETT J R.Clinical presentation of lung cancer[M].Philadelphia,Pa.:Lippincott-Raven,1996:421-435.
[50]SIEGEL R,MA J,ZOU Z,et al.Cancer statistics,2014[J].CA Cancer J Clin,2014,64(1):9-29.DOI:10.3322/caac.21208.
[51]王垚青,孙希文,徐长青,等.应用Lung Care软件评估孤立性肺结节[J].中国医学计算机成像杂志,2012,18(4):307-311.DOI:10.3969/j.issn.1006-5741.2012.04.005.WANG Y Q,SUN X W,XU C Q.et al.Application of Lung Care software in evaluating solitary pulmonary nodules[J].Chinese Computed Medical Imaging,2012,18(4):307-311.DOI:10.3969/j.issn.1006-5741.2012.04.005.
[2]王俊,刘彦国.肺内小结节的诊治现状、问题和方向[J].中华胸心血管外科杂志,2012,28(7):385-386,389.DOI:10.3760/cma.j.issn.1001-4497.2012.07.001.WANG J,LIU Y G.Current status of diagnosis and treatment,problems and directions of small pulmonary nodules[J].Chinese Journal of Thoracic and Cardiovascular Surgery,2012,28(7):385-386,389.DOI:10.3760/cma.j.issn.1001-4497.2012.07.001.
[3]SWENSEN S J,SILVERSTEIN M D,ILSTRUP D M,et al.The probability of malignancy in solitary pulmonary nodules.Application to small radiologically indeterminate nodules[J].Arch Intern Med,1997,157(8):849-855.DOI:10.1001/archin te.1997.00440290031002.
[4]YANG L,ZHANG Q,BAI L,et al.Assessment of the cancer risk factors of solitary pulmonary nodules[J].Oncotarget,2017,8(17):29318-29327.DOI:10.18632/oncotarget.16426.
[5]MCWILLIAMS A,TAMMEMAGI M C,MAYO J R,et al.Probability of cancer in pulmonary nodules detected on first screening CT[J].N Engl J Med,2013,369(10):910-919.DOI:10.1056/NEJMoa1214726.
[6]TORRE L A,BRAY F,SIEGEL R L,et al.Global cancer statistics,2012[J].CA Cancer J Clin,2015,65(2):87-108.DOI:10.3322/caac.21262.
[7]IARC Working Group on the Evaluation of Carcinogenic Risks to Humans.Personal habits and indoor combustions.Volume 100 E.A review of human carcinogens[J].IARC Monogr Eval Carcinog Risks Hum,2012,100(Pt E):1-538.
[8]BAI C,CHOI C M,CHU C M,et al.Evaluation of pulmonary nodules:clinical practice consensus guidelines for Asia[J].Chest,2016,150(4):877-893.DOI:10.1016/j.chest.2016.02.650.
[9]GóMEZ-SáEZ N,HERNáNDEZ-AGUADO I,VILAR J,et al.Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study[J].Eur Radiol,2015,25(12):3518-3527.DOI:10.1007/s00330-015-3775-3.
[10]MITCHELL P S,PARKIN R K,KROH E M,et al.Circulating micro RNAs as stable blood-based markers for cancer detection[J].Proc Natl Acad Sci U S A,2008,105(30):10513-10518.DOI:10.1073/pnas.0804549105.
[11]GENG Q,FAN T,ZHANG B,et al.Five micro RNAs in plasma as novel biomarkers for screening of early-stage non-small cell lung cancer[J].Respir Res,2014,15(1):149.DOI:10.1186/s12931-014-0149-3.
[12]LI X,ZHANG Q,JIN X,et al.Combining serum mi RNAs,CEA,and CYFRA21-1 with imaging and clinical features to distinguish benign and malignant pulmonary nodules:a pilot study:Xianfeng Li et al.:Combining biomarker,imaging,and clinical features to distinguish pulmonary nodules[J].World J Surg Oncol,2017,15(1):107.DOI:10.1186/s12957-017-1171-y.
[13]刘慧,李永怀,桂淑玉.肺癌患者血清肿瘤标记物检测的临床意义及预后评估[J].临床肺科杂志,2014,19(12):2219-2223.DOI:10.3969/j.issn.1009-6663.2014.012.030.LIU H,LI Y H,GUI S Y.Clinical significance and prognostic evaluation of serum tumor markers in patients with lung cancer[J].Journal of Clinical Pulmonary Medicine,2014,19(12):2219-2223.DOI:10.3969/j.issn.1009-6663.2014.012.030.
[14]BELLIER J,PERENTES J Y,ABDELNOUR-BERCHTOLD E,et al.A plea for thoracoscopic resection of solitary pulmonary nodule in cancer patients[J].Surg Endosc,2017,31(11):4705-4710.DOI:10.1007/s00464-017-5543-8.
[15]SHI C Z,ZHAO Q,LUO L P,et al.Size of solitary pulmonary nodule was the risk factor of malignancy[J].J Thorac Dis,2014,6(6):668-676.DOI:10.3978/j.issn.2072-1439.2014.06.22.
[16]张用,毕建平,皮国良,等.国际肺癌研究协会第八版国际肺癌TNM分期修订稿解读[J].肿瘤防治研究,2016,43(4):313-318.DOI:10.3971/j.issn.1000-8578.2016.04.016.ZHANG Y,BI J P,PI G L,et al.An interpretation of revised version of international association for study of lung cancer for forthcoming 8th edition of TNM classification for lung cancer[J].Cancer Research on Prevention and Treatment,2016,43(4):313-318.DOI:10.3971/j.issn.1000-8578.2016.04.016.
[17]HATTORI A,MATSUNAGA T,TAKAMOCHI K,et al.Importance of ground glass opacity component in clinical stage IA radiologic invasive lung cancer[J].Ann Thorac Surg,2017,104(1):313-320.DOI:10.1016/j.athoracsur.2017.01.076.
[18]WINER-MURAM H T,JENNINGS S G,TARVER R D,et al.Volumetric growth rate of stageⅠlung cancer prior to treatment:serial CT scanning[J].Radiology,2002,223(3):798-805.DOI:10.1148/radiol.2233011026.
[19]AHN M I,GLEESON T G,CHAN I H,et al.Perifissural nodules seen at CT screening for lung cancer[J].Radiology,2010,254(3):949-956.DOI:10.1148/radiol.09090031.
[20]龚拥军,包宏伟.CT像上支气管充气征的再分析[J].实用医学影像杂志,2009,10(1):21-23,57.DOI:10.3969/j.issn.1009-6817.2009.01.008.GONG Y J,BAO H W.Further analysis of air bronchograms on CT images[J].Journal of Practical Medical Imaging,2009,10(1):21-23,57.DOI:10.3969/j.issn.1009-6817.2009.01.008.
[21]于瀚宇,尹志伊,徐峰,等.青岛地区肺团块或肺结节病人的病因调查及分析[J].世界最新医学信息文摘,2016,16(5):151-152.DOI:10.3936/j.issn.1671-3141.2016.05.121.YU H Y,YI Z Y,XU F,et al.The investigation and analysis of etiological factor about pulmonary mass or pulmonary nodules in Qingdao area[J].The World's Latest Medical Information Abstracts,2016,16(5):151-152.DOI:10.3936/j.issn.1671-3141.2016.05.121.
[22]LEE H J,KIM Y T,KANG C H,et al.Epidermal growth factor receptor mutation in lung adenocarcinomas:relationship with CT characteristics and histologic subtypes[J].Radiology,2013,268(1):254-264.DOI:10.1148/radiol.13112553.
[23]DAI J,SHI J,SOODEEN-LALLOO A K,et al.Air bronchogram:a potential indicator of epidermal growth factor receptor mutation in pulmonary subsolid nodules[J].Lung Cancer,2016,98:22-28.DOI:10.1016/j.lungcan.2016.05.009.
[24]LEE H Y,LEE K S.Ground-glass opacity nodules:h i s t o p a t h o l o g y,i m a g i n g e v a l u a t i o n,a n d c l i n i c a l implications[J].J Thorac Imaging,2011,26(2):106-118.DOI:10.1097/RTI.0b013e3181fbaa64.
[25]王自立,黄胜,栗兵,等.肺局灶性磨玻璃密度结节(f GGO)的多层螺旋CT(MSCT)特征与病灶良恶性的相关性分析[J].中国CT和MRI杂志,2016,14(2):49-51.DOI:10.3969/j.issn.1672-5131.2016.02.017.WANG Z L,HUANG S,LI B,et al.Correlation analysis of multi-slice spiral CT(MSCT)features of focal ground-glass opacity(f GGO)and the property of the pulmonary lesions[J].Chinese Journal of CT and MRI,2016,14(2):49-51.DOI:10.3969/j.issn.1672-5131.2016.02.017.
[26]AOKI T,HANAMIYA M,URAMOTO H,et al.Adenocarcinomas with predominant ground-glass opacity:correlation of morphology and molecular biomarkers[J].Radiology,2012,264(2):590-596.DOI:10.1148/radiol.12111337.
[27]LEE H Y,CHOI Y L,LEE K S,et al.Pure ground-glass opacity neoplastic lung nodules:histopathology,imaging,and management[J].AJR Am J Roentgenol,2014,202(3):W224-233.DOI:10.2214/AJR.13.11819.
[28]BERRY M F,GAO R,KUNDER C A,et al.Presence of even a small ground glass component in lung adenocarcinoma predicts better survival[J].Clin Lung Cancer,2017.DOI:10.1016/j.cllc.2017.06.020.
[29]MA J,YANG Y L,WANG Y,et al.Relationship between computed tomography morphology and prognosis of patients with stageⅠnon-small cell lung cancer[J].Onco Targets Ther,2017,10:2249-2256.DOI:10.2147/OTT.S114960.
[30]么娜,刘巍.肺内恶性孤立性小结节的CT征象特征分析与诊断[J].临床肺科杂志,2016,21(8):1493-1495.DOI:10.3969/j.issn.1009-6663.2016.08.039.YAO N,LIU W.Analysis and diagnosis of CT syndrome characteristics of solitary pulmonary nodules[J].Journal of Clinical Pulmonary Medicine,2016,21(8):1493-1495.DOI:10.3969/j.issn.1009-6663.2016.08.039.
[31]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.DOI:10.13437/j.cnki.jcr.2016.10.014.CHEN X M,HAO Y X,LI R G,et al.T1a stage lung adenocarcinomas:CT features and pathological findings[J].Journal of Clinical Radiology,2016,35(10):1502-1506.DOI:10.13437/j.cnki.jcr.2016.10.014.
[32]LEE S M,PARK C M,GOO J M,et al.Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as groundglass nodules:differentiation by using CT features[J].R a d i o l o g y,2 0 1 3,2 6 8(1):2 6 5-2 7 3.D O I:10.1148/radiol.13120949.
[33]ERASMUS J J,CONNOLLY J E,MCADAMS H P,et al.Solitary pulmonary nodules:PartⅠ.Morphologic evaluation for differentiation of benign and malignant lesions[J].Radiographics,2000,20(1):43-58.DOI:10.1148/radiogra phics.20.1.g00ja0343.
[34]HERDER G J,VAN TINTEREN H,GOLDING R P,et al.Clinical prediction model to characterize pulmonary nodules:validation and added value of 18F-fluorodeoxyglucose positron emission tomography[J].Chest,2005,128(4):2490-2496.DOI:10.1378/chest.128.4.2490.
[35]崔军胜.分叶征在孤立性肺结节CT诊断中的价值[J].中国现代药物应用,2012,6(19):37-38.DOI:10.14164/j.cnki.cn11-5581/r.2012.19.025.CUI J S.The value of lobulation syndrome in the diagnosis of solitary pulmonary nodule[J].Chinese Journal of Modern Drug Application,2012,6(19):37-38.DOI:10.14164/j.cnki.cn11-5581/r.2012.19.025.
[36]张福康,马军,陈境弟,等.肺炎性假瘤的CT表现与误诊分析[J].影像诊断与介入放射学,2011,20(3):186-189.DOI:10.3969/issn.1005-8001.2011.03.007.ZHANG F K,MA J,CHEN J D,et al.Diagnostic CT features of pulmonary inflammatory pseudotumor[J].Diagnosis Imaging and Interventional Radiology,2011,20(3):186-189.DOI:10.3969/issn.1005-8001.2011.03.007.
[37]蒋彬,孙天宇,邓波,等.孤立性肺结节良、恶性危险因素分析和外科诊治[J].中国胸心血管外科临床杂志,2016,23(7):702-705.DOI:10.7507/1007-4848.20160168.JIANG B,SUN T Y,DENG B,et al.Character of solitary pulmonary nodules:analysis of risk factors and surgical treatment[J].Chinese Journal of Clinical Thoracic and Cardiovascular Surgery,2016,23(7):702-705.DOI:10.7507/1007-4848.20160168.
[38]肖刚.胸膜凹陷征在周围型肺癌与结核球鉴别诊断中的价值[J].内蒙古中医药,2011,30(21):102.DOI:10.3969/j.issn.1006-0979.2011.21.100.XIAO G.The value of pleural indentation in differential diagnosis of peripheral lung cancer and tuberculoma[J].Inner Mongol Journal of Traditional Chinese Medicine,2011,30(21):102.DOI:10.3969/j.issn.1006-0979.2011.21.100.
[39]CHU Z G,SHENG B,LIU M Q,et al.Differential diagnosis of solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography[J].Clinics(Sao Paulo),2016,71(10):555-561.DOI:10.6061/clinics/2016(10)01.
[40]MURRMANN G B,VAN VOLLENHOVEN F H,MOODLEY L.Approach to a solid solitary pulmonary nodule in two different settings-"Common is common,rare is rare"[J].J Thorac Dis,2014,6(3):237-248.DOI:10.3978/j.issn.2072-1439.2013.11.13.
[41]OST D,FEIN A.Management strategies for the solitary pulmonary nodule[J].Curr Opin Pulm Med,2004,10(4):272-278.DOI:10.1097/01.mcp.0000130322.11513.c8.
[42]王秋萍,金晨望,邓蕾,等.探讨肺结节内钙化密度与钙化征象的临床意义[J].医学影像学杂志,2014,24(10):1729-1733.WANG Q P,JIN C W,DENG L,et al.Clinical value of calcification density and signs in the diagnosis of lung nodules[J].Journal of Medical Imaging,2014,24(10):1729-1733.
[43]MAHONEY M C,SHIPLEY R T,CORCORAN H L,et al.CT demonstration of calcification in carcinoma of the lung[J].AJR Am J Roentgenol,1990,154(2):255-258.DOI:10.2214/ajr.154.2.2153329.
[44]GIOVINO G A,MIRZA S A,SAMET J M,et al.Tobacco use in 3 billion individuals from 16 countries:an analysis of nationally representative cross-sectional household surveys[J].Lancet,2012,380(9842):668-679.DOI:10.1016/S0140-6736(12)61085-X.
[45]PARKIN D M,BRAY F,FERLAY J,et al.Global cancer statistics,2002[J].CA Cancer J Clin,2005,55(2):74-108.DOI:10.3322/canjclin.55.2.74.
[46]CHEN K Y,HSIAO C F,CHANG G C,et al.Estrogen receptor gene polymorphisms and lung adenocarcinoma risk in never-smoking women[J].J Thorac Oncol,2015,10(10):1413-1420.DOI:10.1097/JTO.0000000000000646.
[47]佘晖,方振剑,陈方榕,等.孤立性肺结节患者临床特征分析[J].中国呼吸与危重监护杂志,2015,14(4):376-379.DOI:10.7507/1671-6205.2015093.SHE H,FANG Z J,CHEN F R,et al.The relationship between clinical characteristics and pathology findings of solitary pulmonary nodules[J].Chinese Journal of Respiratory and Critical Care Medicine,2015,14(4):376-379.DOI:10.7507/1671-6205.2015093.
[48]RENA O,DAVOLI F,Boldorini R,et al.The solitary pulmonary nodule in patients with previous cancer history:results of surgical treatment[J].Eur J Surg Oncol,2013,39(11):1248-1253.DOI:10.1016/j.ejso.2013.08.014.
[49]MIDTHUN D E,JETT J R.Clinical presentation of lung cancer[M].Philadelphia,Pa.:Lippincott-Raven,1996:421-435.
[50]SIEGEL R,MA J,ZOU Z,et al.Cancer statistics,2014[J].CA Cancer J Clin,2014,64(1):9-29.DOI:10.3322/caac.21208.
[51]王垚青,孙希文,徐长青,等.应用Lung Care软件评估孤立性肺结节[J].中国医学计算机成像杂志,2012,18(4):307-311.DOI:10.3969/j.issn.1006-5741.2012.04.005.WANG Y Q,SUN X W,XU C Q.et al.Application of Lung Care software in evaluating solitary pulmonary nodules[J].Chinese Computed Medical Imaging,2012,18(4):307-311.DOI:10.3969/j.issn.1006-5741.2012.04.005.