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薄层计算机断层扫描对肺腺癌浸润前病变的分析

Analysis of pre-invasive lung adenocarcinoma lesions on thin-section computerized tomography.

作者信息

Xing Yanfen, Li Zhen, Jiang Sen, Xiang Wenjing, Sun Xiwen

机构信息

Department of Radiology, Traditional Chinese Medicine Hospital of Laiwu, Laiwu, Shandong, China.

Department of Ultrasound, Maternal and Child Health Care Hospital of Laiwu, Laiwu, Shandong, China.

出版信息

Clin Respir J. 2015 Jul;9(3):289-96. doi: 10.1111/crj.12142. Epub 2014 May 21.

Abstract

INTRODUCTION

Recent studies have revealed a potential relationship between the presence of ground glass opacity (GGO) on regular computerized tomography (CT) and adenocarcinomas.

OBJECTIVES

To investigate features of pre-invasive lung adenocarcinoma lesions on thin-section CT.

METHODS

We evaluated 59 cases of atypical adenomatous hyperplasia (AAH) and 35 cases of adenoma in situ (AIS) confirmed by histopathology. Comparison of thin-section CT features, such as size, shape, margin, internal characteristics, and adjacent structures of pre-invasive lesions were analyzed. Lesions were further classified to pure ground glass opacity (pGGO) and mixed ground glass opacity (mGGO). Differences were analyzed using Chi-square or Fisher tests.

RESULTS

There were significant differences in lobulation, spiculation, and bubble lucency between pGGO and mGGO (P < 0.05), while no differences in air bronchogram, pleural indentation, or vascular morphological changes were identified (P > 0.05). In the group of pGGO, AAH and AIS lesions did not differ significantly in size (P > 0.05), while significant differences were found with respect to lobulation, spiculation, pleural indentation, and vascular morphological changes (P < 0.05). In the group of mGGO, AAH and AIS lesions were significantly different with respect to size (P < 0.05), while no differences were found in lobulation, spiculation, bubble lucency, air bronchogram, or pleural indentation (P > 0.05). Only vascular morphological changes were significantly different between AAH and AIS lesions (P < 0.05).

CONCLUSION

The features of thin-slice CT of AAH and AIS reflected the corresponding morphological changes from AAH progressing to AIS or adenocarcinoma.

摘要

引言

近期研究揭示了常规计算机断层扫描(CT)上磨玻璃影(GGO)的出现与腺癌之间的潜在关系。

目的

探讨薄层CT上肺腺癌浸润前病变的特征。

方法

我们评估了59例经组织病理学证实的非典型腺瘤样增生(AAH)和35例原位腺癌(AIS)。分析了浸润前病变的薄层CT特征,如大小、形状、边缘、内部特征和相邻结构。病变进一步分为纯磨玻璃影(pGGO)和混合磨玻璃影(mGGO)。使用卡方检验或费舍尔检验分析差异。

结果

pGGO和mGGO在分叶、毛刺和气泡透亮方面存在显著差异(P<0.05),而在空气支气管征、胸膜凹陷或血管形态改变方面未发现差异(P>0.05)。在pGGO组中,AAH和AIS病变在大小上无显著差异(P>0.05),而在分叶、毛刺、胸膜凹陷和血管形态改变方面存在显著差异(P<0.05)。在mGGO组中,AAH和AIS病变在大小上存在显著差异(P<0.05),而在分叶、毛刺、气泡透亮、空气支气管征或胸膜凹陷方面未发现差异(P>0.05)。只有血管形态改变在AAH和AIS病变之间存在显著差异(P<0.05)。

结论

AAH和AIS的薄层CT特征反映了从AAH进展为AIS或腺癌的相应形态学变化。

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