对CT值≤-560HU的肺部纯磨玻璃样结节中浸润性肺腺癌的研究

doi:10.3969/j.issn.2095-3755.2018.04.003

结核病与肺部健康杂志 ›› 2018, Vol. 7 ›› Issue (4): 236-240.doi: 10.3969/j.issn.2095-3755.2018.04.003

对CT值≤-560HU的肺部纯磨玻璃样结节中浸润性肺腺癌的研究

胡帅,李梦颖,车思雨,韩广庆,刘芯言,刘爱连,李智勇()

116011 大连医科大学附属第一医院放射科

收稿日期:2018-10-24 出版日期:2018-12-30 发布日期:2019-01-08
通信作者: 李智勇 E-mail:zjy_lzy@126.com
基金资助:
大连市医学科学研究计划项目(2016QN009)

Study of invasive adenocarcinoma as pulmonary pure ground glass nodules with CT value less than -560HU using thin-slice CT

Shuai HU,Meng-ying LI,Si-yu CHE,Guang-qing HAN,Xin-yan LIU,Ai-lian LIU,Zhi-yong LI()

The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

Received:2018-10-24 Online:2018-12-30 Published:2019-01-08
Contact: Zhi-yong LI E-mail:zjy_lzy@126.com

摘要/Abstract

摘要：

目的探讨CT值≤-560HU的肺部纯磨玻璃样结节(pure ground glass nodule,pGGN)中浸润性腺癌(invasive adenocarcinoma,IA)浸润性判定的薄层CT表现特征。方法收集2015年10月至2017年11在大连医科大学附属第一医院经手术和病理证实并术前均有薄层CT扫描、且CT值≤-560HU的pGGN患者144例,分为IA组8例和非IA组136例(包括非典型腺瘤样增生、原位腺癌、微浸润性腺癌)。在薄层CT图像上测量所有pGGN的最长径。结果在CT值≤-560HU的肺部pGGN中,IA组最长径平均为(2.00±0.71)cm,明显大于非IA组[(0.92±0.43)cm],差异有统计学意义(t=-4.495,P=0.003)。ROC曲线分析,AUC=0.94,最佳截断值为1.10cm时,敏感度为100.00%。结论 CT值≤-560HU的肺部pGGN病灶的最长径是预测IA浸润性的最佳指标,截断值为1.10cm。

关键词: 腺癌,细支气管肺泡, 孤立性肺结节, 体层摄影术,X线计算机, 肿瘤分期, 预测

Abstract:

Objective To explore imaging characteristics of invasive adenocarcinoma (IA) as pulmonary pure ground glass nodule (pGGN) with CT value less than -560HU using thin-slice CT.Methods One hundred and forty-four patients with pGGN of CT value less than -560HU confirmed by surgical pathology in the First Affiliated Hospital of Dalian Medical University were enrolled in this study. They were divided into two groups: 8 patients in IA and 136 in non-IA (including atypical adenomatous hyperplasia, adenocarcinoma in situ, microinvasive adenocarcinoma). All patients performed thin-slice CT scan. We measured the maximum diameters of pGGN.Results The maximum diameter of pGGN with CT value less than -560HU in IA group (2.00±0.71cm) was significantly larger than non-IA group (0.92±0.43cm)(t=-4.495,P=0.003),AUC=0.94, best cut-off value was 1.10cm, sensitivity was 100.00%.Conclusion The maximum diameter of pGGN with CT value less than -560HU is an optimum parameter to predict IA when cut-off value of maximum diameter is set up 1.10cm.

Key words: Adenocarcinoma, bronchiolo-alveolar, Solitary pulmonary nodule, Tomography, X-ray computed, Neoplasm staging, Forecasting

胡帅,李梦颖,车思雨,韩广庆,刘芯言,刘爱连,李智勇. 对CT值≤-560HU的肺部纯磨玻璃样结节中浸润性肺腺癌的研究[J]. 结核病与肺部健康杂志, 2018, 7(4): 236-240. doi: 10.3969/j.issn.2095-3755.2018.04.003

Shuai HU,Meng-ying LI,Si-yu CHE,Guang-qing HAN,Xin-yan LIU,Ai-lian LIU,Zhi-yong LI. Study of invasive adenocarcinoma as pulmonary pure ground glass nodules with CT value less than -560HU using thin-slice CT[J]. Journal of Tuberculosis and Lung Health, 2018, 7(4): 236-240. doi: 10.3969/j.issn.2095-3755.2018.04.003

图/表 10

表1

CT值≤-560HU 的pGGN患者临床资料在IA组和非IA组间的分布及比较

临床资料	非IA组(136例)	IA组(8例)	统计学检验值	P值
年龄(岁, $x ˉ$ ±s)	56.80±10.40	62.40±7.80	-1.465^a	0.145
吸烟史[例(构成比,%)]			0.000^b	1.000
是	10(7.35)	1(12.50)
否	126(92.65)	7(87.50)
病灶CT表现
病灶最长径(cm, $x ˉ$ ±s)	0.92±0.43	2.00±0.71	-4.495^a	0.003
CT值(HU, $x ˉ$ ±s)	-648.82±54.11	-621.50±33.01	-1.387^a	0.168
胸膜牵拉征[例(发生率,%)]	2(1.47)	1(12.50)	0.986^b	0.403
空泡征[例(发现率,%)]	23(16.91)	2(25.00)	0.013^b	0.924

表1

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参考文献 11

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对CT值≤-560HU的肺部纯磨玻璃样结节中浸润性肺腺癌的研究

Study of invasive adenocarcinoma as pulmonary pure ground glass nodules with CT value less than -560HU using thin-slice CT

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