肺腺癌GGNs的多排螺旋CT诊断在判定微浸润中的价值
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摘要
目的研究肺腺癌磨玻璃结节(GGNs)的多排螺旋CT诊断在判定微浸润中的价值。方法选择2016年1月至2018年7月本院呼吸科及胸外科收治的肺腺癌患者作为研究对象,在征得患者及其家属同意的前提下对所有入选的患者行多排螺旋CT检查,有效观察对象128例。收集所有入选患者的基本资料,分析肺腺癌GGNs的多排螺旋CT诊断的结果、价值以及影响诊断结果的相关因素。结果多排螺旋CT对肺腺癌GGNs的诊断结果与患者原始诊断结果无明显差异(P>0.05);多排螺旋CT结果对肺腺癌GGNs检测结果的ROC曲线下面积为0.783(95%CI:0.636~0.905)。影响多排螺旋CT结果对肺腺癌GGNs诊断结果的相关因素包括患者年龄、呼吸系统慢性炎症、新发、吸烟年限(P<0.05)。结论肺腺癌GGNs的多排螺旋CT诊断在判定微浸润中具有较优质的诊断价值,但多排螺旋CT定性结果可能会受到患者自身因素的影响,在作出诊断时需结合相关资料进一步分析。
Objective To study the value of multi-slice spiral CT in the diagnosis of ground glass nodules(GGNs) in lung adenocarcinoma in determining microinvasion. Methods From January 2016 to July 2018, the patients with lung adenocarcinoma admitted in the respiratory department and thoracic surgery department of our hospital were selected as the study objects and examined by multi-slice spiral CT with the consent of the patients and their families, and 128 cases were pbserved effectively. The basic data of all selected patients were collected, result and value of the multi-slice spiral CT in the diagnosis of GGNs of lung adenocarcinoma and the relevant factors affecting diagnosis results were analyzed. Results There was no significant difference between result of multi-slice spiral CT in the diagnosis of result of GGNs in lung adenocarcinoma and the original diagnosis(P>0.05). The area under ROC curve of GGNs of lung adenocarcinoma detected by multi-slice spiral CT was 0.783(95%CI: 0.636-0.905). Related factors affecting the diagnosis of GGNs in patients with lung adenocarcinoma by multi-slice spiral CT included age, chronic respiratory inflammation, new onset and smoking duration(P<0.05). Conclusion Multi-slice spiral CT diagnosis of lung adenocarcinoma GGNs has a high diagnostic value in determining micro-invasion. However, the qualitative results of multi-slice spiral CT may be affected by the patients' own factors, and further analysis should be made in conjunction with relevant data.
Objective To study the value of multi-slice spiral CT in the diagnosis of ground glass nodules(GGNs) in lung adenocarcinoma in determining microinvasion. Methods From January 2016 to July 2018, the patients with lung adenocarcinoma admitted in the respiratory department and thoracic surgery department of our hospital were selected as the study objects and examined by multi-slice spiral CT with the consent of the patients and their families, and 128 cases were pbserved effectively. The basic data of all selected patients were collected, result and value of the multi-slice spiral CT in the diagnosis of GGNs of lung adenocarcinoma and the relevant factors affecting diagnosis results were analyzed. Results There was no significant difference between result of multi-slice spiral CT in the diagnosis of result of GGNs in lung adenocarcinoma and the original diagnosis(P>0.05). The area under ROC curve of GGNs of lung adenocarcinoma detected by multi-slice spiral CT was 0.783(95%CI: 0.636-0.905). Related factors affecting the diagnosis of GGNs in patients with lung adenocarcinoma by multi-slice spiral CT included age, chronic respiratory inflammation, new onset and smoking duration(P<0.05). Conclusion Multi-slice spiral CT diagnosis of lung adenocarcinoma GGNs has a high diagnostic value in determining micro-invasion. However, the qualitative results of multi-slice spiral CT may be affected by the patients' own factors, and further analysis should be made in conjunction with relevant data.
引文
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[9]刘佳,李文武,黄勇,等.表现为磨玻璃密度结节的肺腺癌浸润前病变与微浸润腺癌的多排螺旋CT影像学征象及其鉴别诊断价值[J].中华肿瘤杂志,2015(8):611-616.
[10] GAO F,LI M,SUN Y,et al.Diagnostic value of contrast-enhanced CT scans in identifying lung adenocarcinomas manifesting as GGNs(ground glass nodules)[J].Medicine,2017,96(43):e7742.
[11] HAN YB,KWON HJ,PARK E,et al.P1.02-027 Minute pulmonary meningothelial-like nodules presenting as multiple ground-glass density nodules(GGNs):a case report[J].J Thorac Oncol,2017,12(11):S1934.
[12]祁闻,赵红,王龙胜,等.肺部磨玻璃结节的高分辨率CT征象对结节良恶性的鉴别诊断价值[J].安徽医学,2019,40(4):402-405.
[13]徐亚楠,赵伟,李铭,等.基于支持向量机的肺CT图像三维磨玻璃结节的提取和识别[J].中国医学物理学杂志,2019,36(4):425-430.
[14]杨杨,蔡兆诚,曹源,等.双源双能量CT增强鉴别肺纯磨玻璃结节浸润前病变与浸润性病变[J].影像诊断与介入放射学,2019,28(2):128-133.
[15]刁竹帅,代月杰,王国华,等.HRCT肺纯磨玻璃结节影像表现与肺腺癌病理新分类的相关性分析[J].医学影像学杂志,2019,29(3):407-409,424.
[16]董会帅,范崇渝,韩云.肺叶切除与肺段切除治疗肺部磨玻璃结节效果的比较[J/OL].中国医科大学学报:1-4[2019-07-02].http://kns.cnki.net/kcms/detail/21.1227.R.20190524.1337.030.html.
[2]樊兴海,杨欢欢,许秀春,等.3 cm以下纯磨玻璃结节肺腺癌的组织学与CT扫描值的相关性研究[J].中国临床医生杂志,2018,46(3):307-310.
[3]戈霞晖,管雯斌,韩锋锋,等.表现为肺部磨玻璃结节的浸润前病变和浸润性腺癌的CT及病理对比研究[J].中国呼吸与危重监护杂志,2017,16(6):561-566.
[4]闫如意,刘军华,王艳茹,等.肺部亚厘米磨玻璃结节的螺旋CT与病理对照分析[J].局解手术学杂志,2018,27(4):275-279.
[5]苗润丰,陶玉坚.持续存在的肺磨玻璃结节临床研究进展[J].医学综述,2018,24(7):1378-1382.
[6]韩丽珠,叶兆祥,李绪斌,等.CT定量参数预测评估肺混合磨玻璃结节侵袭性的临床价值[J].中国肿瘤临床,2018,45(6):286-290.
[7]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.
[8]陈昕,陈小岩,陈前顺,等.表现为磨玻璃样结节非鳞屑样浸润性肺腺癌的临床病理学特征及其预后[J].福建医药杂志,2017,39(6):35-37.
[9]刘佳,李文武,黄勇,等.表现为磨玻璃密度结节的肺腺癌浸润前病变与微浸润腺癌的多排螺旋CT影像学征象及其鉴别诊断价值[J].中华肿瘤杂志,2015(8):611-616.
[10] GAO F,LI M,SUN Y,et al.Diagnostic value of contrast-enhanced CT scans in identifying lung adenocarcinomas manifesting as GGNs(ground glass nodules)[J].Medicine,2017,96(43):e7742.
[11] HAN YB,KWON HJ,PARK E,et al.P1.02-027 Minute pulmonary meningothelial-like nodules presenting as multiple ground-glass density nodules(GGNs):a case report[J].J Thorac Oncol,2017,12(11):S1934.
[12]祁闻,赵红,王龙胜,等.肺部磨玻璃结节的高分辨率CT征象对结节良恶性的鉴别诊断价值[J].安徽医学,2019,40(4):402-405.
[13]徐亚楠,赵伟,李铭,等.基于支持向量机的肺CT图像三维磨玻璃结节的提取和识别[J].中国医学物理学杂志,2019,36(4):425-430.
[14]杨杨,蔡兆诚,曹源,等.双源双能量CT增强鉴别肺纯磨玻璃结节浸润前病变与浸润性病变[J].影像诊断与介入放射学,2019,28(2):128-133.
[15]刁竹帅,代月杰,王国华,等.HRCT肺纯磨玻璃结节影像表现与肺腺癌病理新分类的相关性分析[J].医学影像学杂志,2019,29(3):407-409,424.
[16]董会帅,范崇渝,韩云.肺叶切除与肺段切除治疗肺部磨玻璃结节效果的比较[J/OL].中国医科大学学报:1-4[2019-07-02].http://kns.cnki.net/kcms/detail/21.1227.R.20190524.1337.030.html.