肺结核患者与肺结核合并肺癌患者的CT影像征象差异。

Differences in CT imaging signs between patients with tuberculosis and those with tuberculosis and concurrent lung cancer.

作者信息

Tang Wencai, Xing Weijin, Li Chuanzi, Nie Zhongshi, Cai Mubin

机构信息

Department of Radiology, The Second Affiliated Hospital of Hainan Medical University Haikou 570311, Hainan, China.

出版信息

Am J Transl Res. 2022 Sep 15;14(9):6234-6242. eCollection 2022.

PMID:36247264

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9556475/

Abstract

OBJECTIVE

The purpose of this study was to compare the differences in imaging features between patients with pulmonary tuberculosis (TB) alone and patients with TB complicated with lung cancer (LCA) as well as to investigate the diagnostic value of CT in these two groups.

METHODS

In this retrospective study, 110 patients with confirmed TB admitted to the Second Affiliated Hospital of Hainan Medical University from March 2020 to April 2021 were collected and divided into TB+LCA group (50 cases, diagnosed with TB complicated with lung cancer) and TB group (60 cases, diagnosed with TB alone) according to actual diagnosis. The CT results of both groups were analyzed by the same group of physicians in a double-blind manner. The diagnostic value of CT for TB alone and TB complicated with lung cancer was calculated. The differences in CT imaging characteristics between the two groups were investigated. The differences in the structural characteristics of para-cancerous tissue between the two groups were analyzed.

RESULTS

The diagnostic accuracy of CT was 91.67% in TB patients (55/60) and 92.00% in TB+LCA patients (46/50) without significant difference ( =0.004, =0.949). The detection rate of spiculation, lobulation and cavitation in TB+LCA group was significantly higher than that in TB group (<0.05), and the distribution, size and wall thickness of cavitation varied significantly between the two groups (<0.05). Patients in TB group had higher percentage of mediastinal lymph node calcification, peripheral satellite lesion, and mediastinal lymph node enlargement around the TB lesions compared with those in TB+LCA group (<0.05).

CONCLUSION

CT has certain application value in differentiating TB alone from TB complicated with lung cancer, and there are many similarities in the imaging features of the two conditions. CT can be considered as a preliminary means of differential diagnosis of TB complicated with lung cancer, which is helpful to the primary screening diagnosis of lung cancer.

摘要

目的

本研究旨在比较单纯肺结核患者与合并肺癌的肺结核患者的影像学特征差异，并探讨CT对这两组患者的诊断价值。

方法

本回顾性研究收集了2020年3月至2021年4月在海南医学院第二附属医院确诊的110例肺结核患者，根据实际诊断分为肺结核合并肺癌组（50例，诊断为肺结核合并肺癌）和单纯肺结核组（60例，诊断为单纯肺结核）。两组的CT结果由同一组医生采用双盲法进行分析。计算CT对单纯肺结核和合并肺癌的肺结核的诊断价值。研究两组CT影像特征的差异。分析两组癌旁组织结构特征的差异。

结果

CT对肺结核患者的诊断准确率为91.67%（55/60），对肺结核合并肺癌患者的诊断准确率为92.00%（46/50），差异无统计学意义（=0.004，=0.949）。肺结核合并肺癌组毛刺征、分叶征和空洞征的检出率显著高于单纯肺结核组（<0.05），两组空洞的分布、大小及壁厚差异有统计学意义（<0.05）。与肺结核合并肺癌组相比，单纯肺结核组患者纵隔淋巴结钙化、周围卫星灶及结核灶周围纵隔淋巴结肿大的比例更高（<0.05）。