摘要
目的探讨不同病理分型肺癌的胸部CT毛刺征特点及其增殖细胞核抗原Ki-67表达的相关性。方法选择2018年3月至2021年5月收治入院接受胸部CT检查的肺癌患者128例,其中其中男性例数70例,女性例数58例;年龄35~77岁,58.80平均年龄(标准差9.04)。根据支气管、穿刺、手术等途径明确病理结果并分组,其中鳞癌组35例,腺癌组80例和小细胞癌组13例。进一步将肺腺癌组根据病理类型分为原位腺癌(AIS)、浸润腺癌(IAC)和微浸润腺癌(MIA)3组,分析不同分类的患者MSCT(MSCT)征象特点。使用免疫组化方法检测癌组织中Ki-67的表达情况,并分析Ki-67表达与胸部CT毛刺征特点的相关性。结果腺癌患者的胸膜凹陷征发生率为57.50%较鳞癌(25.71%)和小细胞癌(7.69%)显著偏高;鳞癌的空泡征发生率为74.29%明显高于腺癌(45.00%)和小细胞癌(15.38%)(P<0.05)。平均大小、平均CT值及毛刺征是AIS与MIA分组的危险因素;平均大小、平均CT值及最大CT值是MIA与AC分组的危险因素。肿瘤恶性程度越高,Ki-67的表达水平越高。相关分析结果显示,Ki-67的表达与肺癌结节密度增加呈高度正相关(r=0.733,P<0.01),与肺癌结节直径、分叶征、毛刺征均呈中度正相关(r=0.661、0.536、0.518,均P<0.01),与胸膜凹陷征呈弱正相关(r=0.302,P<0.01),与肺癌结节空泡征无相关性(r=0.147,P>0.05)。结论不同病理分型肺癌胸部CT征象存在明显差异,可通过分析CT征象辅助临床判断肺癌患者的病理类型,此外肿瘤的MSCT征象可在一定程度上也可指示Ki-67的表达水平。
Objective To investigate the correlation of chest CT burr features and expression of proliferating nuclear antigen Ki-67 in different pathological types of lung cancer.Methods 128 patients with lung cancer were selected from March 2018 to May 2021 for chest CT examination,including 70 males and 58 females.Age 35-77 years,58.80 mean age(SD 9.04).Pathological findings were determined and grouped according to bronchus,puncture and operation,including 35 cases in squamous cell carcinoma group,80 cases in adenocarcinoma group and 13 cases in small cell carcinoma group.Lung Adenocarcinoma group was further divided into Adenocarcinoma in situ(AIS),Invasive adenocarcinoma(IAC)and Microinvasive adenocarcinoma(Microinvasive adenocarcinoma)according to pathological types.Multislice spiral CT(MSCT)features were analyzed in MIA(3 groups).The expression of Ki-67 in cancer tissues was detected by immunohistochemical method,and the correlation between Ki-67 expression and the burr sign of chest CT was analyzed.Results the incidence of pleural depression in adenocarcinoma patients(57.50%)was significantly higher than that of squamous cell carcinoma(25.71%)and small cell carcinoma(7.69%).The incidence of vacuolar signs in squamous cell carcinoma(74.29%)was significantly higher than that in adenocarcinoma(45.00%)and small cell carcinoma(15.38%)(P<0.05).Average size,average CT value and burr sign were risk factors for AIS and MIA grouping.Mean size,mean CT value and maximum CT value were risk factors for MIA and AC grouping.The higher the malignant degree of the tumor,the higher the expression level of Ki-67.Correlation analysis showed that the expression of Ki-67 was highly positively correlated with the increase of lung cancer nodular density(r=0.733,P<0.01),had moderate positive correlation with nodule diameter,lobular sign and burr sign(r=0.661,0.536,0.518,all P<0.01),had a weak positive correlation with pleural depression sign(r=0.302,P<0.01),there was no correlation with vacuolar signs of lung cancer nodules(r=0.147,P<0.05).Conclusion there are obvious differences in chest CT signs among different pathological types of lung cancer.The analysis of CT signs can assist clinical diagnosis of the pathological types of lung cancer patients.In addition,the MSCT signs of tumors can also indicate the expression level of Ki-67 to a certain extent.
作者
王大恺
翁镇
苏艳辉
于子卿
WANG Da-kai;WENG Zhen;SU Yan-hui;YU Zi-qing(Department of CT-MRI,The second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei Province,China;Department of Thoracic Surgery,The second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,Hebei Province,China)
出处
《中国CT和MRI杂志》
2025年第10期49-52,共4页
Chinese Journal of CT and MRI
基金
邢台市科技局重点研发计划项目(2021ZC173)。
关键词
病理分型
肺癌
胸部CT
毛刺征特点
KI-67
相关性分析
Pathological Classification
Lung Cancer
Chest CT
Burr Ssign Characteristics
Ki-67
Correlation Analysis
