Aoki T, Tomoda Y, Watanabe H, Nakata H, Kasai T, Hashimoto H, Kodate M, Osaki T, Yasumoto K
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi 807-8555, Japan.
Radiology. 2001 Sep;220(3):803-9. doi: 10.1148/radiol.2203001701.
To evaluate the prognostic importance of thin-section computed tomographic (CT) findings of peripheral lung adenocarcinomas.
The subjects were 127 patients with adenocarcinomas smaller than 3 cm in largest diameter who underwent at least a lobectomy with hilar and mediastinal lymphadenectomy. The margin characteristics of nodules and the extent of ground-glass opacity (GGO) within the nodules at preoperative thin-section CT were analyzed retrospectively. Regional lymph node metastasis (LNM) and vessel invasion (VI) were histologically examined in surgical specimens. Survival curves were calculated according to the Kaplan-Meier method.
The frequencies of LNM (4% [1 of 24]) and VI (13% [three of 24]) in adenocarcinomas with GGO components of more than 50% were significantly lower than those with GGO components of less than 10% (LNM, P <.05; VI, P <.01). The patients with GGO components of more than 50% showed a significantly better prognosis than those with GGO components less than 50% (P <.05). All 17 adenocarcinomas smaller than 2 cm with GGO components of more than 50% were free of LNM and VI, and all these patients are alive without recurrence. Coarse spiculation and thickening of bronchovascular bundles around the tumors were observed more frequently in tumors with LNM or VI than in those without LNM or VI (P <.01).
Thin-section CT findings of peripheral lung adenocarcinomas correlate well with histologic prognostic factors.
评估周围型肺腺癌薄层计算机断层扫描（CT）表现的预后重要性。
研究对象为127例最大直径小于3 cm的腺癌患者，这些患者均接受了至少肺叶切除术及肺门和纵隔淋巴结清扫术。回顾性分析术前薄层CT扫描时结节的边缘特征及结节内磨玻璃影（GGO）的范围。对手术标本进行组织学检查，以确定区域淋巴结转移（LNM）和血管侵犯（VI）情况。采用Kaplan-Meier法计算生存曲线。
GGO成分超过50%的腺癌患者中LNM（4% [24例中的1例]）和VI（13% [24例中的3例]）的发生率显著低于GGO成分小于10%的腺癌患者（LNM，P <.05；VI，P <.01）。GGO成分超过50%的患者预后明显好于GGO成分小于50%的患者（P <.05）。所有17例直径小于2 cm且GGO成分超过50% 的腺癌均无LNM和VI，所有这些患者均存活且无复发。LNM或VI的肿瘤比无LNM或VI的肿瘤更常观察到肿瘤周围的粗毛刺征和支气管血管束增粗（P <.01）。
周围型肺腺癌的薄层CT表现与组织学预后因素密切相关。
