摘要
目的对比分析不同浸润程度的磨玻璃结节(GGN)样肺腺癌的多层螺旋CT(MSCT)特征及在临床上的诊断价值。方法选取洛阳市中心医院2021年1月至2024年10月收集的142例经手术后病理学结果确诊的GGN样肺腺癌患者,其中原位肺腺癌患者48例(浸润前组)、已经发生微浸润肺腺癌患者41例(微浸润组)、已经发生浸润性腺癌患者53例(浸润组),对比三组患者在接受手术治疗前的MSCT检查特征、定量指标,并分别绘制受试者操作特征曲线(ROC)计算MSCT检查在鉴别诊断浸润前病变、微浸润肺腺癌及浸润性肺腺癌中的实际价值。结果浸润组、微浸润组患者的病灶直径大于浸润前组(P<0.05);浸润组、微浸润组患者病灶形态呈类圆形占比、血管集束征检出比、胸膜凹陷征占比均高于浸润前组(P<0.05);浸润组患者的病灶直径大于微浸润组(P<0.05);浸润组患者病灶形态呈类圆形占比、血管集束征检出比、胸膜凹陷征占比均高于微浸润组(P<0.05);MSCT鉴别诊断GGN病灶发生微浸润病变、浸润前病变的灵敏度为80.49%、特异度为77.08%、曲线下面积(AUC)为0.788;MSCT鉴别诊断GGN病灶发生浸润病变、浸润前病变的灵敏度为90.57%、特异度为89.58%、AUC为0.901;MSCT鉴别诊断GGN病灶发生浸润病变、微浸润病变的灵敏度为64.15%、特异度为70.73%、AUC为0.674(P<0.05)。结论根据MSCT影像学特征,能较为有效的鉴别诊断GGN样肺腺癌是否发生浸润病变,对于指导临床诊疗具有重要意义。
【Objective】To compare the multi-slice spiral CT(MSCT)features and analyze its clinical diagnostic value for ground glass nodule(GGN)-like lung adenocarcinoma.【Methods】A total of 142 patients with GGN-like lung adenocarcinoma diagnosed by postoperative pathological results were selected from Luoyang Central Hospital from January 2021 to October 2024,including 48 patients with in situ lung adenocarcinoma(pre-invasive group),41 patients with micro-invasive lung adenocarcinoma(micro-invasive group),and 53 patients with invasive lung adenocarcinoma(invasive group).The characteristics and quantitative indicators of MSCT before surgical treatment were compared among the three groups,and receiver operating characteristic(ROC)curve was drawn respectively to calculate the actual value of MSCT in the differential diagnosis of preinvasive lesions,microinvasive lung adenocarcinoma and invasive lung adenocarcinoma.【Results】The lesion diameter of the invasive group and the micro-invasive group was larger than that of the pre-invasive group,and the difference was statistically significant(P<0.05).The proportion of lesions with circular shape,the detection ratio of vascular cluster sign and the incidence of pleural depression in the invasive group and the micro-invasive group were significantly higher than those in the pre-invasive group,with statistical significance(P<0.05).The lesion diameter in invasive group was larger than that in micro-invasive group,and the difference was statistically significant(P<0.05).The proportion of lesions with circular shape,the proportion of vascular cluster sign detection and the proportion of pleural depression in the invasive group were significantly higher than those in the micro-invasive group,with statistical significance(P<0.05).The sensitivity,specificity and area under the curve(AUC)of MSCT were 80.49%,77.08%and 0.788 respectively in differentiating microinvasive lesions and pre-invasive lesions in GGN lesions.The sensitivity and specificity of MSCT were 90.57%,89.58%,and the AUC value of area under ROC curve was 0.901 in in the differential diagnosis of invasive lesions and pre-invasive lesions in GGN lesions.The sensitivity and specificity of MSCT were 64.15%,70.73%,and the AUC value under ROC curve was 0.674 in the differential diagnosis of infiltration and microinfiltration of GGN lesions(P<0.05).【Conclusion】According to the imaging characteristics of MSCT,it is of great significance to differentiate the infiltrating lesions of GGN-like lung adenocarcinoma effectively,which is of great significance to guide clinical diagnosis and treatment.
作者
郭景曲
GUO Jingqu(Deartment of Medical Imaging,Luoyang Central Hospital,Luoyang,Henan 471000,China)
出处
《中国医学工程》
2025年第11期64-69,共6页
China Medical Engineering
关键词
浸润程度
磨玻璃结节
肺腺癌
多层螺旋CT
鉴别诊断
受试者操作特征曲线
infiltration degree
ground glass nodules
lung adenocarcinoma
multislice spiral CT
differential diagnosis
receiver operating characteristic curve
