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[1]許德新,林鏗強(qiáng),陳樹興,等.肺磨玻璃結(jié)節(jié)的影像學(xué)特征在浸潤(rùn)性肺腺癌中的診斷價(jià)值[J].福建醫(yī)藥雜志,2023,45(05):12-16.
　XU Dexin,LIN Kengqiang,CHEN Shuxing,et al.Diagnostic value of imaging features of lung ground-glass nodules in invasive lung adenocarcinoma[J].FUJIAN MEDICAL JOURNAL,2023,45(05):12-16.
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肺磨玻璃結(jié)節(jié)的影像學(xué)特征在浸潤(rùn)性肺腺癌中的診斷價(jià)值()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期數(shù):
2023年05期
頁(yè)碼:
12-16
欄目:
臨床研究
出版日期:
2023-10-15

文章信息/Info

Title:
Diagnostic value of imaging features of lung ground-glass nodules in invasive lung adenocarcinoma
文章編號(hào):
1002-2600(2023)05-0012-05
作者:
許德新; 林鏗強(qiáng); 陳樹興; 潘閃; 代祖建1; 王超平2
福建省福州肺科醫(yī)院胸外科(福州 350007)
Author(s):
XU Dexin;  LIN Kengqiang;  CHEN Shuxing;  PAN Shan;  DAI Zujian;  WANG Chaoping
Department of Thoracic Surgery, Fuzhou Pulmonary Hospital, Fuzhou, Fujian 350007, China
關(guān)鍵詞:
肺腺癌;  磨玻璃結(jié)節(jié);  電子計(jì)算機(jī)斷層掃描;  危險(xiǎn)因素;  診斷價(jià)值
Keywords:
lung adenocarcinoma;  ground-glass nodule;  computed tomography;  risk factors;  diagnostic value
分類號(hào):
R445.3; R734.2
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 探討肺磨玻璃結(jié)節(jié)的影像學(xué)特征在浸潤(rùn)性肺腺癌中的診斷價(jià)值。方法 回顧性選擇我院2010年1月至2012年1月期間首次經(jīng)胸部CT發(fā)現(xiàn)肺磨玻璃結(jié)節(jié),并最終接受外科手術(shù)確診為早期肺腺癌的157例患者作為研究對(duì)象,根據(jù)術(shù)后病理結(jié)果將其分為浸潤(rùn)癌組68例和微浸潤(rùn)癌及原位癌組89例。比較兩組患者肺磨玻璃結(jié)節(jié)的影像學(xué)特征; 將存在統(tǒng)計(jì)學(xué)差異的影像學(xué)特征因素納入logistic回歸分析,篩選出預(yù)測(cè)肺磨玻璃結(jié)節(jié)達(dá)到浸潤(rùn)的危險(xiǎn)因素; 對(duì)各危險(xiǎn)因素進(jìn)行ROC曲線分析,以判斷各危險(xiǎn)因素的診斷價(jià)值。結(jié)果 浸潤(rùn)癌組患者相對(duì)CT值、結(jié)節(jié)最大徑大于微浸潤(rùn)癌及原位癌組,浸潤(rùn)癌組胸膜凹陷征、毛刺征、分葉征、空泡征、血管集束征的患者占比更高,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。logistic回歸分析結(jié)果顯示,相對(duì)CT值、結(jié)節(jié)最大徑、分葉征、毛刺征為浸潤(rùn)性腺癌發(fā)生的危險(xiǎn)因素,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。ROC曲線分析,結(jié)節(jié)最大徑的最佳臨界值為1.55 cm,AUC為0.897[95%CI(0.846,0.948)]; 相對(duì)CT值的最佳臨界值為394 Hu,AUC為0.908[95%CI(0.863,0.953)]; 結(jié)節(jié)最大徑和相對(duì)CT值聯(lián)合的AUC為0.977[95%CI(0.957,0.997)]。結(jié)論 結(jié)節(jié)最大徑、相對(duì)CT值、分葉征、毛刺征為預(yù)測(cè)肺磨玻璃結(jié)節(jié)浸潤(rùn)的危險(xiǎn)因素,聯(lián)合預(yù)測(cè)效能更佳。
Abstract:
Objective To investigate the diagnostic value of the imaging features of lung ground-glass nodules in invasive lung adenocarcinoma.Methods A total of 157 patients who were firstly found lung ground-glass nodules by chest CT and finally diagnosed as early stage lung adenocarcinoma by surgical operation from January 2010 to January 2012 were retrospectively selected.They were devided into invasive carcinoma group(68 cases)and minimally invasive carcinoma and carcinoma in situ group(89 cases)according to the postoperative pathologic results.The imaging characteristics of lung ground-glass nodules of patients in the two groups were compared; the factors with statistically different imaging characteristics were included in logistic regression analysis to screen out the risk factors for predicting lung ground-glass nodules to reach invasiveness; ROC curve analysis was carried out for each risk factor to determine the diagnostic value of each risk factor.Results The relative CT value and the maximum diameter of the nodule in the invasive carcinoma group were larger than those in the minimally invasive carcinoma and carcinoma in situ group, and the percentage of patients with pleural depression sign, burr sign, lobular sign, vacuolar sign, and vascular cluster sign was higher in the invasive carcinoma group, and the differences were statistically significant(P<0.05).Logistic regression analysis showed that the relative CT value, the maximum diameter of the nodule, the lobular sign, and the burr sign were risk factors for the invasive adenocarcinoma, and the differences were statistically significant(P<0.05).ROC curve analysis showed that the optimal critical value of nodal maximum diameter was 1.55 cm, with an AUC of 0.897 [95%CI(0.846, 0.948)]; the optimal critical value of relative CT value was 394 Hu, with an AUC of 0.908 [95%CI(0.863, 0.953)]; and the combined nodal AUC for the combination of maximum diameter and relative CT value was 0.977 [95%CI(0.957, 0.997)].Conclusion Maximum nodal diameter, relative CT value, lobulation sign and burr sign are risk factors for predicting invasiveness of pulmonary ground-glass nodules, and the combination of these factors are more effective in predicting invasiveness.

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備注/Memo

備注/Memo:
基金項(xiàng)目:福州市科技計(jì)劃項(xiàng)目(2021-S-193);
1 通信作者,Email:[email protected]; 2 影像科
更新日期/Last Update: 2023-10-15