Sun Li, Zhang Binbin, Li Pulin, Fei Guanghe, Wang Ran
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
J Cancer. 2024 Sep 23;15(18):6016-6021. doi: 10.7150/jca.92408. eCollection 2024.
This study aimed to assess the diagnostic value of target scanning combined with three-dimensional reconstruction in early-stage lung adenocarcinoma. A retrospective analysis was conducted on 2017 patients with pathologically confirmed early-stage lung adenocarcinoma who underwent thoracoscopic lobectomy at the First Affiliated Hospital of Anhui Medical University from September 2018 to May 2023. These patients were initially diagnosed using conventional spiral CT scanning, and the study explored the application of target scanning combined with three-dimensional reconstruction in the diagnosis of early-stage lung adenocarcinoma. the pulmonary nodules were classified into three groups according to the pathological classification: Pre-Invasive lesion (PI), Microinvasive adenocarcinoma (MIA), and Invasive adenocarcinoma (IA), there were significant differences in the mean diameter of pulmonary nodules, the mean diameter of solid components, the proportion of solid components, pleural indentation, lobulation, spinous process, spiculation, and vascular convergence among the three groups. There were no significant differences between conventional spiral CT scanning and target scanning combined with three-dimensional reconstruction in terms of the number of cases with pure ground-glass nodules, mixed density nodules, pure solid nodules, the detection rate of vacuole signs, the CT value of the solid component and ground-glass component, and the maximum nodule diameter (P>0.05). However, target scanning combined with three-dimensional reconstruction detected a higher number of cases with lobulation signs, spinous process signs, pleural depression signs, burr signs, vessel convergence signs, and larger maximum diameters of the solid component compared to conventional spiral CT scanning (P<0.05). Target scanning combined with three-dimensional reconstruction provides more reliable imaging evidence for the diagnosis of early-stage lung adenocarcinoma, particularly in identifying specific signs and characterizing solid components.
本研究旨在评估靶扫描联合三维重建在早期肺腺癌中的诊断价值。对2017例2018年9月至2023年5月在安徽医科大学第一附属医院接受胸腔镜肺叶切除术且病理确诊为早期肺腺癌的患者进行回顾性分析。这些患者最初采用传统螺旋CT扫描进行诊断，本研究探讨靶扫描联合三维重建在早期肺腺癌诊断中的应用。根据病理分类将肺结节分为三组：原位腺癌（PI）、微浸润腺癌（MIA）和浸润性腺癌（IA），三组之间肺结节的平均直径、实性成分平均直径、实性成分比例、胸膜凹陷、分叶、棘突、毛刺和血管集束存在显著差异。在纯磨玻璃结节、混合密度结节、纯实性结节病例数、空泡征检出率、实性成分和磨玻璃成分的CT值以及最大结节直径方面，传统螺旋CT扫描与靶扫描联合三维重建之间无显著差异（P>0.05）。然而，与传统螺旋CT扫描相比，靶扫描联合三维重建检测出分叶征、棘突征、胸膜凹陷征、毛刺征、血管集束征的病例数更多，且实性成分的最大直径更大（P<0.05）。靶扫描联合三维重建为早期肺腺癌的诊断提供了更可靠的影像学证据，尤其是在识别特定征象和对实性成分进行特征描述方面。
