[1]许德新,林铿强,陈树兴,等.肺磨玻璃结节的影像学特征在浸润性肺腺癌中的诊断价值[J].福建医药杂志,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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肺磨玻璃结节的影像学特征在浸润性肺腺癌中的诊断价值()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年05期
页码:
12-16
栏目:
临床研究
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
文章编号:
1002-2600(2023)05-0012-05
作者:
许德新; 林铿强; 陈树兴; 潘闪; 代祖建1; 王超平2
福建省福州肺科医院胸外科(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
关键词:
肺腺癌;  磨玻璃结节;  电子计算机断层扫描;  危险因素;  诊断价值
Keywords:
lung adenocarcinoma;  ground-glass nodule;  computed tomography;  risk factors;  diagnostic value
分类号:
R445.3; R734.2
文献标志码:
B
摘要:
目的 探讨肺磨玻璃结节的影像学特征在浸润性肺腺癌中的诊断价值。方法 回顾性选择我院2010年1月至2012年1月期间首次经胸部CT发现肺磨玻璃结节,并最终接受外科手术确诊为早期肺腺癌的157例患者作为研究对象,根据术后病理结果将其分为浸润癌组68例和微浸润癌及原位癌组89例。比较两组患者肺磨玻璃结节的影像学特征; 将存在统计学差异的影像学特征因素纳入logistic回归分析,筛选出预测肺磨玻璃结节达到浸润的危险因素; 对各危险因素进行ROC曲线分析,以判断各危险因素的诊断价值。结果 浸润癌组患者相对CT值、结节最大径大于微浸润癌及原位癌组,浸润癌组胸膜凹陷征、毛刺征、分叶征、空泡征、血管集束征的患者占比更高,差异均有统计学意义(P<0.05)。logistic回归分析结果显示,相对CT值、结节最大径、分叶征、毛刺征为浸润性腺癌发生的危险因素,差异有统计学意义(P<0.05)。ROC曲线分析,结节最大径的最佳临界值为1.55 cm,AUC为0.897[95%CI(0.846,0.948)]; 相对CT值的最佳临界值为394 Hu,AUC为0.908[95%CI(0.863,0.953)]; 结节最大径和相对CT值联合的AUC为0.977[95%CI(0.957,0.997)]。结论 结节最大径、相对CT值、分叶征、毛刺征为预测肺磨玻璃结节浸润的危险因素,联合预测效能更佳。
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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备注/Memo

备注/Memo:
基金项目:福州市科技计划项目(2021-S-193);
1 通信作者,Email:283864380@qq.com; 2 影像科
更新日期/Last Update: 2023-10-15