High resolution CT in differentiating minimally invasive component in early lung adenocarcinoma
High resolution CT in differentiating minimally invasive component in early lung adenocarcinoma
复制标题
高分辨率 CT 区分早期肺腺癌的微创成分。
DOI：
10.1016/j.lungcan.2014.02.008
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发表时间：
2014-06-01
期刊：
影响因子：
5.3
通讯作者：
Zhang, Jie
中科院分区：
文献类型：
--
作者：
Zhang, Yu;Qiang, Jin Wei;Zhang, Jie
目的：分析早期肺腺癌的高分辨率计算机断层扫描（HRCT）表现，探讨HRCT对早期肺腺癌微创成分的鉴别价值。材料与方法：回顾性分析140例早期肺腺癌结节（直径小于2cm）的HRCT表现。所有结节均经手术和病理证实，其中60例为微创腺癌（MIA）结节，80例为侵袭前病变（PL）结节。采用单因素logistic回归分析比较两组肺结节的HRCT特征，包括形状、边缘、形态、直径、实性成分直径、血管改变、支气管气征、空泡、胸膜压痕和多样性。采用非配对t检验或Wilcoxon秩和检验比较纯毛玻璃结节、纯毛玻璃成分和混合毛玻璃结节固体成分的衰减值。结果：两组在形态、切缘、形态、直径、实性成分直径、肺静脉改变、支气管气征、胸膜压痕等方面差异均有统计学意义（优势比[OR] = 3.115 [P = 0.001]、OR = 3.754 [P = 0.011]、OR = 9.815 [P = 0.000]、OR = 1.306 [P = 0.000]、OR = 1.361 [P = 0.031]、OR = 6.971 [P = 0.000]、OR = 6.167 [P = 0.000]、OR = 2.296 [P = 0.027]）。固体成分衰减值差异有统计学意义（t = 3.702, P = 0.000）。经多因素logistic分析，固体成分衰减值与MIA显著相关（OR = 1.005, P = 0.032）。MIA多为较大的分叶状或不规则混合磨玻璃结节，实性成分大于5mm，衰减值较高。此外，MIA常伴有肺静脉、支气管气征和胸膜压痕的异常。结论：HRCT可显示早期肺腺癌的形态学特征，识别微创成分。2014爱思唯尔爱尔兰有限公司版权所有。
Objectives: To analyze high-resolution computed tomography (HRCT) appearances of early lung adenocarcinoma and evaluate HRCT in the differentiation of minimally invasive component in early lung adenocarcinoma.Materials and methods: HRCT appearances of 140 nodules (less than 2 cm in diameter) of early lung adenocarcinoma were reviewed retrospectively. All these nodules were proven by surgery and pathology including 60 nodules of minimally invasive adenocarcinoma (MIA) and 80 nodules of preinvasive lesion (PL). HRCT features of two groups of lung nodules, including shape, margin, pattern, diameter, diameter of solid component, vascular changes, air bronchogram, vacuole, pleural indentation and multiplicity were analyzed and compared using univariate logistic regression analysis. Attenuation values of pure ground-glass nodule, pure ground-glass component and solid component of mixed ground-glass nodule were compared by using unpaired t-test or Wilcoxon rank-sum test.Results: The statistically significant differences were found in shape, margin, pattern, diameter, diameter of solid component, pulmonary vein changes, air bronchogram and pleural indentation (Odds ratio [OR] = 3.115 [P = 0.001], OR = 3.754 [P = 0.011], OR = 9.815 [P = 0.000], OR = 1.306 [P = 0.000], OR = 1.361 [P = 0.031], OR = 6.971 [P = 0.000], OR = 6.167 [P = 0.000], OR = 2.296 [P = 0.027], respectively). The statistically significant difference was also found in attenuation value of solid component (t = 3.702, P = 0.000). By multivariate logistic analysis, attenuation value of solid component was significantly associated with MIA (OR = 1.005, P = 0.032). MIA was more often a larger, lobulated or irregular, mixed ground-glass nodule with a solid component larger than 5 mm, and higher attenuation values. In addition, MIA often had an abnormality in pulmonary vein, air bronchogram and pleural indentation.Conclusions: HRCT can demonstrate the morphological features of early lung adenocarcinoma and identify minimally invasive component. (C) 2014 Elsevier Ireland Ltd. All rights reserved.