摘要
目的 观察支气管动脉灌注 (BAI)对中央型支气管肺癌的疗效并进行CT与病理学对照研究。方法 对2 7例经组织学证实的中央型支气管肺癌进行支气管动脉灌注 (BAI)治疗 ,通过对比疗前、疗后CT评价原发灶及纵隔淋巴结等的改变 ;2 1例BAI治疗后限期手术切除 ,对照分析其疗后CT和病理学的表现。结果 疗后病灶较前缩小2 3例 (2 3/ 2 7) ,纵隔肿大淋巴结疗后较前缩小 16例 (16 / 2 2 ) ,BAI治疗后病灶与周围结构关系有改善者 8例 (8/ 19) ,BAI后肺不张明显改善或消失 12例 (12 / 15 ) ,BAI治疗使病变T分期下降 8例 (8/ 2 7) ,使病变N分期下降 1例 (1/2 7) ,临床分期下降 2例 (2 / 2 7)。BAI后病理学检查发现残存肿瘤细胞周围伴有坏死 (10 / 2 1)、间质纤维化 (10 / 2 1)等成分 ,有时可有出血 (1/ 2 1)或钙化 (2 / 2 1)等。BAI后手术切除病例中 ,5 (5 / 2 1)例在原发灶及纵隔淋巴结内均未发现残存肿瘤成分。坏死成分的CT表现为肿瘤中心的不规则低密度区 ,或伴有空洞 (6 / 10 )。其余病理改变没有特征性的CT表现。结论 支气管动脉灌注 (BAI)治疗对中央型支气管肺癌有较好的近期疗效。CT扫描可以从病变大小和密度的改变方面评价BAI的疗效 ,但在反应残存肿瘤及肿瘤坏死、纤维化的构成比等组织学改变方面 。
Objective To describe the changes of primary tumor and mediastinal lymph nodes of lung cancer on CT after bronchial arterial infusion (BAI) and to correlate the CT findings with pathology. Methods 27 patients with histologically confirmed lung cancer underwent BAI .Changes of primary tumor and mediastinal lymph nodes before and after therapy were assessed using CT.Of 21 cases were performed operation after BAI .The CT findings were correlated with pathologic findings. Results With BAI therapy ,primary tumor was reduced in diameter in 23(23/27) cases and mediastinal lymph node was reduced in diameter in 16(16/22) cases. Decrease in T and N staging was achieved in 8(8/27) and 1(1/27) cases respectively ,decrease in clinical staging was achieved in 2 (2/27)cases.On pathological examination,the remaining tumor consisted of residual tumor cells,fibrosis(10/21),necrosis(10/21),hemorrhage(1/21) or calcification(2/21) and so on. No residual tumor cell was found in both primary tumor and mediastinal lymph nodes in 5(5/21) cases after BAI.The CT findings of necrotic area of the tumor after BAI were low attenuation area with irregular edge or with cavity(6/10). The CT findings of other pathological changes were not characteristics. Conclusion BAI therapy is useful for central bronchiogenic lung cancer.To some extent,CT is an effective method for assessing the effect of BAI by determining the size and density of primary tumor and mediastinal lymph nodes ,but it is limited in predicting the pathological changes after therapy.
出处
《中国医学影像技术》
CSCD
2001年第1期54-56,共3页
Chinese Journal of Medical Imaging Technology
基金
国家九五攻关项目! (96 90 7 0 3 0 3)
关键词
肺癌
分期
介入治疗
化治疗
CT
Lung cancer
Staging
Interventional therapy
Chemotherapy
Computed tomography
