肺磨玻璃结节CT血管征在肺腺癌病理分型中的鉴别诊断价值

Value of CT vascular signs of lung ground-glass nodule in differential diagnosis of pathologic subtypes of lung adenocarcinoma

  • 摘要: 目的 分析肺磨玻璃结节(GGN)与周围血管的关系及分型,探讨其对肺腺癌病理分型的鉴别诊断价值。 方法 回顾性分析经手术获得病理结果的92例GGN患者(100个GGN)的临床资料,将其分为浸润前病变组(48个)、微浸润性腺癌(MIA)组(30个)、浸润性腺癌(IAC)组(22个)。根据GGN与周围血的关系分为4型,即Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型。 结果 本研究中,浸润前病变组GGN大小为(7.99±3.18)mm, MIA组GGN大小为(8.75±2.87)mm, IAC组GGN大小为(13.47±4.48)mm。浸润前病变组、MIA组分别与IAC组GGN比较,差异有统计学意义(P < 0.05)。浸润前病变组与MIA组、浸润前病变组与IAC组、MIA组与IAC组比较,周围血管征的差异均有统计学意义(P < 0.01)。含有不同比例磨玻璃成分的GGN与血管征分型的关系比较发现, A类与B类、A类与C类、B类与C类的周围血管征分型比较均有显著差异(P < 0.01)。 结论 GGN周围血管征对鉴别诊断肺腺癌病理分型有重要的临床意义,结合GGN的大小及其内所含磨玻璃成分比例可进一步提高鉴别诊断的准确率。

     

    Abstract: Objective To analyze the relationship and typing between ground-glass nodule(GGN)and peripheral blood vessels, and to explore its value in differential diagnosis of pathological classification of lung adenocarcinoma. Methods The clinical data of 92 patients with GGN(100 GGN)were analyzed retrospectively. They were divided into three groups, that were pre-invasion lesion group(n=48), microinvasive adenocarcinoma(MIA)group(n=30)and invasive adenocarcinoma(IAC)group(n=22). According to the relationship between GGN and peripheral blood, it can be divided into four types, that were type Ⅰ, type Ⅱ, type Ⅲ and type Ⅳ. Results In this study, the size of GGN was(7.99±3.18)mm in the pre-invasion lesion group,(8.75±2.87)mm in the MIA group and(13.47±4.48)mm in the IAC group. There were significant differences in GGN size between IAC group and pre-invasion lesion group as well as MIA group(P < 0.05). There were significant differences in peripheral vascular signs between every two groups(P < 0.01). The relationship between GGN with different proportion of ground glass components and vascular classification revealed that there were significant differences in typing of peripheral vascular signs between class A and class B, class A and class C, and class B and class C(P < 0.01). Conclusion The peripheral vascular- sign of GGN play an important role in the differential diagnosis of lung adenocarcinoma, and the accuracyof differential diagnosis can be further improved by combining the size of GGN and the proportion of ground-glass opacity contained in GGN.

     

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