HRCT Features of Small Peripheral Lung Carcinomas Detected in a Low-dose CT Screening Program
HRCT Features of Small Peripheral Lung Carcinomas Detected in a Low-dose CT Screening Program
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DOI：
10.1016/j.acra.2009.08.003
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发表时间：
2010-01-01
影响因子：
4.8
通讯作者：
Haniuda, Masayuki
中科院分区：
文献类型：
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作者：
Sone, Shusuke;Matsumoto, Toru;Haniuda, Masayuki
理由与目的：根据组织病理学和预后，定义计算机断层扫描（CT）筛查发现肺癌的高分辨率计算机断层扫描（HRCT）特征。方法与材料：对1996 ~ 1998 ~ 2007年间10例非典型腺瘤性增生（AAH）患者和50例肺癌患者的肿瘤大小、CT值、形态及肿瘤体积倍增时间（TVDT）进行了测定。结果：10例aah病灶密度均小于-500 HU（平均-654 HU），大小均达14 mm（平均9 mm）；所有病人都还活着。局灶性细支气管肺泡细胞癌（BAC）的密度（平均-537 HU）高于AAH，大多数密度低于-350 HU；所有病人都还活着。22例腺癌（ADC）均大于-450 HU（平均-186 HU）；6例有问题，测量>-150HU和>10mm或>10mm的中心致密区（CDZ）（部分实体瘤）或肿瘤大小（实体瘤）。四分之二的鳞状细胞癌（SCC）分别为15和10毫米，是有问题的。两名小细胞肺癌（SCLC）患者分别为15和23毫米，仍然存活。AAH、BAC、ADC和SCC病变一般呈多边形。SCLC病变表现为圆形结节伴赘生物。AAH、BAC、ADC、SCC和SCLC的平均TVDT分别为1278、557,466,212和103天。结论：CT表现反映了肿瘤的侵袭性。非sclc病变>-150HU和>0mm（或>-100HU和>0mm的实性部分肿瘤）与不良预后相关。在病例数量出现问题增加之前，应及时采取干预措施。
Rationale and Objectives: To define high-resolution computed tomography (HRCT) features of lung cancers detected by computed tomography (CT) screening according to histopathology and prognosis.Methods and Materials: Tumor size, CT value, morphology, and tumor volume doubling time (TVDT) were determined for 10 atypical adenomatous hyperplasias (AAH) and 50 lung cancers followed between 1996 and 1998 to 2007.Results: For the 10 AAHs, the density less than -500 HU in all lesions (mean, -654 HU) and the size was up to 14 mm (mean, 9 mm); all patients remain alive. Focal bronchioloalveolar cell carcinomas (BAC) were denser (mean, -537 HU) than AAH and mostly less dense than -350 HU; all patients remain alive. All 22 adenocarcinomas (ADC) were denser than -450 HU (mean, -186 HU); 6 were problematic and measured >-150HU and >10 mm or had >10 mm of central denser zone (CDZ) (partly solid tumors) or tumor size (solid tumor). Two of four squamous cell carcinomas (SCC) measuring 15 and 10 mm, respectively, were problematic. Two patients with small-cell lung carcinomas (SCLC) measuring 15 and 23 mm, respectively, remain alive. AAH, BAC, ADC, and SCC lesions were in general polygonal in shape. SCLC lesions appeared as round nodules with excrescence. The mean TVDT for AAH, BAC, ADC, SCC, and SCLC was 1278, 557,466,212, and 103 days, respectively.Conclusion: The CT features reflected tumor aggressiveness. Non-SCLC lesions of >-150HU and >10 mm (or >-100HU and >10 mm for the solid portion of the tumor) are associated with unfavorable prognosis. Timely interventions should be undertaken before problematic increase in number of cases.