Ge Xiaojun, Gao Feng, Li Ming, Chen Yan, Lü Fanzhen, Ren Qingguo, Hua Yanqing
Department of Radiology, Affiliated Huadong Hospital, Fudan University, Shanghai 200040, China.
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Zhonghua Yi Xue Za Zhi. 2014 Apr 8;94(13):1010-3.
To explore the feasibility of making a preoperative diagnosis of lung adenocarcinoma shown as ground-glass nodule (GGN) on computed tomography (CT).
A total of 143 GGN lesions proved pathologically were divided randomly into A and B groups. Then each group was further divided pathologically into preinvasive lesion, minimal invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IAC) subgroups. Group A (n = 101), size of lesion, proportion of ground glass opacity (GGO) composition of lesion, long diameter, longest diameter and size of solid component in lesion were measured on CT so as to establish the CT diagnostic standard of lung adenocarcinoma shown as GGN on CT. Group B (n = 42) was employed to evaluate the accuracy of the above CT diagnostic standard. SPSS 17.0 software was used for statistical analysis.
Significant statistic significance existed in all parameters among all groups (P < 0.05). All parameters were correlated the pathologic type of lesion. The differences were statistically significant (P = 0.000). Through the receiver operating characteristic (ROC) curve, between groups of preinvasive lesion and MIA, each parameter had a medium diagnostic value of 0.70-0.90; between groups of MIA and IAC, size of lesion and long diameter of solid component in lesion had a medium diagnostic value of 0.70-0.90, longest diameter of solid component, size of solid component in lesion and proportion of GGO composition of lesion had a high diagnostic value with an AUC of >0.90. The CT diagnostic standard, derived from group A, was used to analyze the pathologic type of group B. And t no significant statistic significance existed between CT preoperative diagnosis and operative pathologic diagnosis (P > 0.05) . The correct diagnosis rates of size of lesion, proportion of GGO composition of lesion, long diameter, longest diameter and size of solid component in lesion were 71.43%, 76.19%, 90.05%, 90.05% and 88.10% respectively.
Based upon size of lesion, proportion of GGO composition of lesion, long diameter, longest diameter and size of solid component in lesion, preoperative CT examination may be used to determine the pathological types of lung adenocarcinoma shown as GGN.
探讨对计算机断层扫描(CT)显示为磨玻璃结节(GGN)的肺腺癌进行术前诊断的可行性。
将143个经病理证实的GGN病变随机分为A组和B组。然后每组再根据病理进一步分为浸润前病变、微浸润腺癌(MIA)和浸润性腺癌(IAC)亚组。A组(n = 101),在CT上测量病变大小、病变磨玻璃密度(GGO)成分比例、长径、最长径以及病变实性成分大小,以建立CT上显示为GGN的肺腺癌的CT诊断标准。B组(n = 42)用于评估上述CT诊断标准的准确性。采用SPSS 17.0软件进行统计分析。
所有组间所有参数均存在显著统计学意义(P < 0.05)。所有参数均与病变的病理类型相关。差异具有统计学意义(P = 0.000)。通过绘制受试者工作特征(ROC)曲线,浸润前病变组与MIA组之间,各参数诊断价值中等,为0.70 - 0.90;MIA组与IAC组之间,病变大小和病变实性成分长径诊断价值中等,为0.70 - 0.90,实性成分最长径、病变实性成分大小及病变GGO成分比例诊断价值高,曲线下面积(AUC)>0.90。用A组得出的CT诊断标准分析B组的病理类型。CT术前诊断与手术病理诊断之间无显著统计学意义(P > 0.05)。病变大小、病变GGO成分比例、长径、最长径及病变实性成分大小的正确诊断率分别为71.43%、76.19%、90.05%、90.05%和88.10%。
基于病变大小、病变GGO成分比例、长径、最长径及病变实性成分大小,术前CT检查可用于判断CT显示为GGN的肺腺癌的病理类型。