摘要
目的研究不同类型肺腺癌患者高分辨CT表现及病理学分析。方法选取本院收治的120例肺腺癌患者作为研究对象,回顾性分析患者高分辨CT影像学资料。根据CT检查结果分为浸润前组36例,微浸润腺癌(MIA)44例,浸润性腺癌(IAC)40例,所有患者均经手术病理确诊,CT检测图像在术前2周内取得。所有患者均接受联影u CT_S-160影像检查;同时行手术病理诊断,由2名资深的病理医师复阅石蜡包埋与HE染色病理切片,针对分型难度较大的病理可由2名医师讨论后决定。观察3组患者肺腺癌病灶位置、病理结果,比较浸润前组患者的不典型腺瘤样增生(AAH)、原位腺癌(AIS)病变最大直径,绘制受试者工作曲线图(ROC)。结果浸润前组患者肺腺癌病灶多发生在右肺上叶、左肺上叶处,MIA病灶多处于右肺上叶、右肺下叶、左肺上叶,IAC病变多处于右肺上叶、右肺下叶、左肺上叶。3组患者肺腺癌病灶位置比较,差异无统计学意义(P>0.05)。病理诊断3组患者肺腺癌病变均表现为非黏液型;AAH病变最大直径低于AIS,差异有统计学意义(P<0.05);ROC曲线显示,曲线下面积(AUC)为0.915,AAH、AIS的鉴别最佳界限值为-687 HU,敏感度为91.50%,特异性为94.82%。结论采用高分辨CT检测肺腺癌能预测其病理新分类,具有较高的敏感性与特异性,在AAH检测方面诊断价值高。不同类型肺腺癌高分辨CT表现存在一定不同,但表现不明显,病灶多发于右肺上叶与左肺上叶,病理学分析表现为非黏液型。
Objective To study the high -resolution CT manifestation （HRCT） and pathological analysis of different types of lung adenocarcinoma. Methods The HRCT imaging data of 120 patients with lung adenocarcinoma admitted into our hospital were retrospectively analyzed. According to CT detection results, they were divided into preinvasive group （n = 36） , micro invasive adenocareinoma （MIA） （ n = 44 ）, invasive adenocarcinoma （IAC） （ n = 40）. All the patients were confirmed by surgery pathology and their CT detection image were achieved in 2 weeks before surgery. All the patients received united imaging uCT_S - 160 image examination, and patients received pathology diagnosis, the paraffin embedding and HE staining pathological section were reviewed by two senior pathol- ogists, and difficult types of pathology can be decided by two doctors after discussion. The position of lesions, pathological results of lung adenocarcinoma in three groups were observed. The maximum lesion diameter of the atypical adenocarcinoma hyperplasia （ AAH）, adenocarcinoma in situ （AIS） in preinvasive group were compared, and receiver operating characteristic curve （ROC） was drew. Results The focus of lung adenocarcinoma of preinvasive group tended to occur in superior lobe of right lung and superior lobe of left lung, MIA focus in superior lobe of right lung, inferior lobe of right lung and superior lobe of left lung, IAC focus in superior lobe of right lung, inferior lobe of right lung and superior lobe of left lung. There was no statistical difference in the position of lesions of lung adenocareinoma among three groups （ P 〉 0.05 ）. The pathological diagnosis showed that the lesion of lung adenocareinoma of three groups performed as non - mutinous type. The maximum diameter of AAH lesion was lower than AIS （P 〈0.05） ; The ROC curve showed that area under curve （AUC） was 0. 915, best threshold value of AAH and AIS was - 687 HU, sensitivity was 91.50%, specificity was 94.82%. Conclusion HRCT for detecting lung adenoearcinoma can predict new pathological types and has higher sensitivity and specificity, which has high diagnostic value in AAH detection. The HRCT manifestations of different types of lung adenocarcinoma have certain differences, but these manifestations were not obvious, the focus tend to occur in superior lobe of right lung and superior lobe of left lung, and the pathological analysis performs as non - mucinous type.
出处
《实用临床医药杂志》
CAS
2017年第24期6-9,共4页
Journal of Clinical Medicine in Practice
基金
湖北省卫计委面上项目(JX62305)
关键词
肺腺癌
高分辨CT表现
病理学
lung adenocarcinoma
high -resolution CT manifestation
pathology
