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[关于直径2厘米及以下切除的小肺结节的高分辨率计算机断层扫描(HRCT)结果与恶性性质相关性的研究]

[A study of high-resolution computed tomography (HRCT) findings of resected small pulmonary nodules 2 cm or less in diameter with reference to the malignant nature].

作者信息

Nakashima Yoshiaki, Yamada T, Tanahashi M, Hikosaka Y, Yoshitomi H, Niwa H

机构信息

Department of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.

出版信息

Kyobu Geka. 2006 Sep;59(10):917-22.

Abstract

To identify the characteristics of peripheral small lung mass lesions on high-resolution computed tomography (HRCT) and discriminate between malignant and benign, 223 mass lesions 2 cm or less resected surgically were evaluated about following points. 1) Density : 90.7% of lesions with mixed solid and ground-glass opacity (GGO) components were adenocarcinomas. Pure GGO lesions without scale-down between several months were all adenocarcinomas or atypical adenomatous hyperplasia (AAH). Thereby, patients with these findings are good candidates for surgical resection. 2) Spicular or pleural indentation :75.2% (88 of 117 cases) of adenocarcinomas and all squamous cell carcinomas (18 cases) showed these findings, but 26.6% (41 of 154 cases) of positive cases were benign lesion (non-specific inflammation, mycobacterisis, and so on). Accordingly, they are not peculiar to malignancy. 3) Satellite lesion : all lesions with this one showed benign, therefore it was thought that this finding could exclude malignant lesion. Thus, recognition of certain characteristics at HRCT can be helpful in discrimination between small malignant mass and benign mass.

摘要

为了确定高分辨率计算机断层扫描(HRCT)上周围型小肺肿块病变的特征,并鉴别其良恶性,我们对223例手术切除的直径2cm及以下的肿块病变进行了如下评估。1)密度:混合实性和磨玻璃密度(GGO)成分的病变中,90.7%为腺癌。数月内无缩小的纯GGO病变均为腺癌或不典型腺瘤样增生(AAH)。因此,有这些表现的患者是手术切除的良好候选者。2)毛刺或胸膜凹陷:75.2%(117例中的88例)的腺癌和所有鳞状细胞癌(18例)有这些表现,但26.6%(154例中的41例)有阳性表现的病例为良性病变(非特异性炎症、分枝杆菌病等)。因此,它们并非恶性肿瘤所特有。3)卫星灶:所有有卫星灶的病变均为良性,因此认为这一表现可排除恶性病变。因此,在HRCT上识别某些特征有助于鉴别小的恶性肿块和良性肿块。

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