中央型和周围型鳞癌患者临床特点及CT影像学特征研究
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摘要
目的研究分析中央型和周围型鳞癌患者临床特点以及CT影像学特征研究。方法选取2013年1月至2018年6月在我院经病理证实的42例肺鳞癌患者作为研究对象,按照病理结果进行分组,其中病理结果为中央型肺鳞癌的22例患者作为中央型肺鳞癌组,结果为周围型肺鳞癌的20例患者作为周围型肺鳞癌组,比较并分析两组患者临床特点以及CT影像学特征。结果两组患者男性患者数明显高于女性,中央型肺鳞癌组患者年龄处于≥45岁和≤60岁的人数明显多于>60岁的患者,周围型肺鳞癌组患者年龄>60岁的患者明显多于年龄处于≥45岁和≤60岁的人数,两组患者具有吸烟史患者数明显高于不具有吸烟史患者,中央型肺鳞癌患者吸烟率明显高于周围型肺鳞癌患者,差异具有统计学意义(P<0.05)。比较两组患者的肿瘤大小以及分期情况,差异具有统计学意义(P<0.05),中央型肺鳞癌组肿瘤大小明显大于周围型肺鳞癌组,差异不具有统计学意义(P>0.05),中央型肺鳞癌组患者分化情况明显差于周围型肺鳞癌组患者,差异具有统计学意义(P<0.05)。中央型肺鳞癌组患者咳嗽、咯血、咳痰、痰中带血、胸痛、胸闷、气喘、转移症状、刺激性干咳、发热、无症状以及其他临床症状特点明显多于周围型肺鳞癌组患者,差异具有统计学意义(P<0.05)。中央型肺鳞癌CT影像学特征以支气管狭窄、肿块为主,周围型肺鳞癌CT影像学特征以结节、分叶征、毛刺征为主。结论中央型肺鳞癌与周围型肺鳞癌的主要临床特点是咳嗽、咯血、咳痰、胸痛、胸闷、发热,中央型肺鳞癌CT影像学特征以支气管狭窄、肿块为主,周围型肺鳞癌CT影像学特征以结节、分叶征、毛刺征为主。
Objective To analyze the clinicalcharacteristics and CT imaging features in patients with central and peripheral squamous cell carcinoma. Methods 42 patients with lung squamous cell carcinoma confirmed by pathology in our hospital between January2013 and June 2017 were divided into as the central lung squamous cell carcinoma group(n=22, patients with central lung squamous cell carcinoma) and peripheral lung squamous cell carcinoma(n=20, patients with peripheral lung squamous cell carcinoma) according to the biopsy results.The clinicalcharacteristics and CT imaging features of two groups were compared and analyzed. Results The number of male patients in the two groups was significantly higher than that of female patients. The patients of ≥45 years old and≤60 years old in the central lung squamous cell carcinoma group were significantly more than those of >60 years old, vice versa in the peripheral lung squamous cell carcinoma group. The number of patients with smoking history in the two groups was significantly higher than that in patients without smoking history;the smoking rate of patients with central lung squamous cell carcinoma was significantly higher than that of peripheral lung squamous cell carcinoma(P<0.05). The tumor size and staging of the two groups were statistically significant(P<0.05). The tumor size of the central lung squamous cell carcinoma group was significantly larger than that of the peripheral lung squamous cell carcinoma group(P>0.05). The differentiation of patients with central squamous cell carcinoma was significantly worse than that of patients with peripheral squamous cell carcinoma(P<0.05). Patients with central lung squamous cell carcinoma had significantly more cough, hemoptysis, cough, blood stasis, chest pain, chest tightness, wheezing,metastatic symptoms, irritating dry cough, fever, asymptomatic and other clinical symptoms than those with peripheral lung squamous cell carcinoma(P<0.05). Conclusion The main clinical characteristics central lung squamous cell carcinoma and peripheral lung squamous cell carcinoma are cough, hemoptysis, cough, hemoptysis, expectoration, chest pain, chest tightness and fever, in which CT imaging features of central lung squamous cell carcinoma are mainly bronchial stenosis and mass and CT imaging features of peripheral lung squamous cell carcinoma are mainly nodule, lobulation sign and burr sign.
Objective To analyze the clinicalcharacteristics and CT imaging features in patients with central and peripheral squamous cell carcinoma. Methods 42 patients with lung squamous cell carcinoma confirmed by pathology in our hospital between January2013 and June 2017 were divided into as the central lung squamous cell carcinoma group(n=22, patients with central lung squamous cell carcinoma) and peripheral lung squamous cell carcinoma(n=20, patients with peripheral lung squamous cell carcinoma) according to the biopsy results.The clinicalcharacteristics and CT imaging features of two groups were compared and analyzed. Results The number of male patients in the two groups was significantly higher than that of female patients. The patients of ≥45 years old and≤60 years old in the central lung squamous cell carcinoma group were significantly more than those of >60 years old, vice versa in the peripheral lung squamous cell carcinoma group. The number of patients with smoking history in the two groups was significantly higher than that in patients without smoking history;the smoking rate of patients with central lung squamous cell carcinoma was significantly higher than that of peripheral lung squamous cell carcinoma(P<0.05). The tumor size and staging of the two groups were statistically significant(P<0.05). The tumor size of the central lung squamous cell carcinoma group was significantly larger than that of the peripheral lung squamous cell carcinoma group(P>0.05). The differentiation of patients with central squamous cell carcinoma was significantly worse than that of patients with peripheral squamous cell carcinoma(P<0.05). Patients with central lung squamous cell carcinoma had significantly more cough, hemoptysis, cough, blood stasis, chest pain, chest tightness, wheezing,metastatic symptoms, irritating dry cough, fever, asymptomatic and other clinical symptoms than those with peripheral lung squamous cell carcinoma(P<0.05). Conclusion The main clinical characteristics central lung squamous cell carcinoma and peripheral lung squamous cell carcinoma are cough, hemoptysis, cough, hemoptysis, expectoration, chest pain, chest tightness and fever, in which CT imaging features of central lung squamous cell carcinoma are mainly bronchial stenosis and mass and CT imaging features of peripheral lung squamous cell carcinoma are mainly nodule, lobulation sign and burr sign.
引文
[1]李星凯,刘战业,姜运峰,等.原发性中央型和周围型肺鳞癌临床病理学及预后差异[J].山东大学学报:医学版,2017,55(9):73-78.
[2]Grimm M,Feyen 0,Hofmann H,e t al.Immunophenotyping of patients with oral squamous cell carcinoma in peripheral blood and as sociated tumor tissue[J].Tumor Biology,2016,37(3):3807-3816.
[3]高垒,杨青,胡亚彬,等.双入口CT灌注评价肺腺癌和肺鳞癌血供特征[J].中国医学影像技术,2017,33(3):419-422.
[4]Yamano S,Gi M,Tago Y,et al.Role of deltaNp63posCD44vpos cells in the development of N-nitroso-trischloroethylurea-induced peripheral-type mouse lung squamous cell carcinomas[J].Cancer Science,2 016,107(2):123-132.
[5]陈子盛,田东波,肖靖华,等.清远地区肺腺癌和鳞癌患者胸部CT征象及免疫组化特征比较研究[J].中国全科医学,2017,20(S2):87-89.
[6]Xiao C,Beitler J J,Higgins K A,et al.Persistent Fatigue Is Associated With Persistent Peripheral Inf lammation in Patients With Squamous Cell Carcinoma of the Head and Neck Cancer up to 3 Months PostIntensi ty Modulated Radiat ion Therapy[J].Internat ional Journal of Radiation Oncology Biology Physics,2016,96(2):E348.
[7]探讨PET/CT原发灶SUVmax在肺鳞癌患者术后预后中的意义及与临床病理特征的关系[J].中国肺癌杂志,2 016,19(4):192-199.
[8]Takahashi H,Sakakura K,Mito I,et a l.Dynamic changes in immune cell profile in head and neck squamous cell carcinoma:Immunomodulatory effec ts of chemot herapy[J].Cancer Science,2 016,107(8):1065-1071.
[9]吴强.周围型肺鳞癌和腺癌MSCT征象与CD14 7和VEGF-C表达的相关性研究[J].中国临床医学影像杂志,2016,27(11):784-787.
[10]复旦大学上海医学院.《实用内科学》第1 3版[J].中国医刊,2009,44(12):43-43.
[11]含薄壁嚢腔周围型肺癌的CT特征及病理基础分析[J].中华放射学杂志,2017,51(2):96-101.
[12]Obata K,Shimo T,Okui T,et al.Tachykinin Receptor 3Distribut ion in Human Oral Squamous Cell Carcinoma[J].Ant i cancer Research,2016,36(12):6335.
[13]逄鑫,王宝华,刘杰.周围型肺癌螺旋CT表现与血清NSE和SCCAg的关系[J].中国老年学杂志,2018,25(5):33-37.
[14]Takahashi H,Sakakura K,Chikamatsu K.Abs tract 4627:Prognostic significance and population shift of peripheral monocytes in patients with oropharyngeal squamous cell carcinoma[J].Cancer Research,2017,77(13 Supplement):462 7-4627.
[15]梁远凤,李琦,马超豪,等.肺癌癌周灌注的能谱CT定量研究[J].重庆医科大学学报,2017,(3):357-360.
[16]Ma J,Zhang Y,Wang J,et al.Proliferative effect s of gamma-amino butyric acid on oral squamous cell carcinomacells are associated with mi togen-ac tiva ted protein kinase signaling pathways[J].International Journal of Molecular Medicine,2 016,38(1):305.
[17]张童童,李峻岭.存在驱动基因突变肺鳞癌患者的临床病理特征及预后分析[J].中国肺癌杂志,2016,19(10):648-652.
[18]Yu Z L,Zhang W,Zhao J Y,et a l.Development of a Dual Modally Traceable Nanoplatform for Cancer Theranost ics Using Natural Circulating CellDerived Microparticles in Oral Cancer Pat ients[J].Advanced Funct ional Materials,2017,27(40):1703482.
[19]吴杰,吴忠纯,肖辉,等.1 3例肺腺鳞癌的CT图像分析[J].山东医药,2017(47):93-94.
[20]Yu,Zi-Li,Zhang W,Zhao,Jin gYa,et a l.Cancer Treatment:Development of a Dual-Modally Traceable Nanoplatform for Cancer Theranos tics Using Natural Circulating CellDerived Microparticles in Oral Cancer Patients(Adv.Funct.Mater.4 0/2 01 7)[J].Advanced Functional Materials,2017,27(40):1703482.
[2]Grimm M,Feyen 0,Hofmann H,e t al.Immunophenotyping of patients with oral squamous cell carcinoma in peripheral blood and as sociated tumor tissue[J].Tumor Biology,2016,37(3):3807-3816.
[3]高垒,杨青,胡亚彬,等.双入口CT灌注评价肺腺癌和肺鳞癌血供特征[J].中国医学影像技术,2017,33(3):419-422.
[4]Yamano S,Gi M,Tago Y,et al.Role of deltaNp63posCD44vpos cells in the development of N-nitroso-trischloroethylurea-induced peripheral-type mouse lung squamous cell carcinomas[J].Cancer Science,2 016,107(2):123-132.
[5]陈子盛,田东波,肖靖华,等.清远地区肺腺癌和鳞癌患者胸部CT征象及免疫组化特征比较研究[J].中国全科医学,2017,20(S2):87-89.
[6]Xiao C,Beitler J J,Higgins K A,et al.Persistent Fatigue Is Associated With Persistent Peripheral Inf lammation in Patients With Squamous Cell Carcinoma of the Head and Neck Cancer up to 3 Months PostIntensi ty Modulated Radiat ion Therapy[J].Internat ional Journal of Radiation Oncology Biology Physics,2016,96(2):E348.
[7]探讨PET/CT原发灶SUVmax在肺鳞癌患者术后预后中的意义及与临床病理特征的关系[J].中国肺癌杂志,2 016,19(4):192-199.
[8]Takahashi H,Sakakura K,Mito I,et a l.Dynamic changes in immune cell profile in head and neck squamous cell carcinoma:Immunomodulatory effec ts of chemot herapy[J].Cancer Science,2 016,107(8):1065-1071.
[9]吴强.周围型肺鳞癌和腺癌MSCT征象与CD14 7和VEGF-C表达的相关性研究[J].中国临床医学影像杂志,2016,27(11):784-787.
[10]复旦大学上海医学院.《实用内科学》第1 3版[J].中国医刊,2009,44(12):43-43.
[11]含薄壁嚢腔周围型肺癌的CT特征及病理基础分析[J].中华放射学杂志,2017,51(2):96-101.
[12]Obata K,Shimo T,Okui T,et al.Tachykinin Receptor 3Distribut ion in Human Oral Squamous Cell Carcinoma[J].Ant i cancer Research,2016,36(12):6335.
[13]逄鑫,王宝华,刘杰.周围型肺癌螺旋CT表现与血清NSE和SCCAg的关系[J].中国老年学杂志,2018,25(5):33-37.
[14]Takahashi H,Sakakura K,Chikamatsu K.Abs tract 4627:Prognostic significance and population shift of peripheral monocytes in patients with oropharyngeal squamous cell carcinoma[J].Cancer Research,2017,77(13 Supplement):462 7-4627.
[15]梁远凤,李琦,马超豪,等.肺癌癌周灌注的能谱CT定量研究[J].重庆医科大学学报,2017,(3):357-360.
[16]Ma J,Zhang Y,Wang J,et al.Proliferative effect s of gamma-amino butyric acid on oral squamous cell carcinomacells are associated with mi togen-ac tiva ted protein kinase signaling pathways[J].International Journal of Molecular Medicine,2 016,38(1):305.
[17]张童童,李峻岭.存在驱动基因突变肺鳞癌患者的临床病理特征及预后分析[J].中国肺癌杂志,2016,19(10):648-652.
[18]Yu Z L,Zhang W,Zhao J Y,et a l.Development of a Dual Modally Traceable Nanoplatform for Cancer Theranost ics Using Natural Circulating CellDerived Microparticles in Oral Cancer Pat ients[J].Advanced Funct ional Materials,2017,27(40):1703482.
[19]吴杰,吴忠纯,肖辉,等.1 3例肺腺鳞癌的CT图像分析[J].山东医药,2017(47):93-94.
[20]Yu,Zi-Li,Zhang W,Zhao,Jin gYa,et a l.Cancer Treatment:Development of a Dual-Modally Traceable Nanoplatform for Cancer Theranos tics Using Natural Circulating CellDerived Microparticles in Oral Cancer Patients(Adv.Funct.Mater.4 0/2 01 7)[J].Advanced Functional Materials,2017,27(40):1703482.