中国肺癌杂志2018，Vol.21Issue(6)：451-457,7.DOI:10.3779/j.issn.1009-3419.2018.06.05
亚实性肺结节CT征象在良恶性鉴别及腺癌恶性侵袭程度评估中的价值
Value of CT Features on Differential Diagnosis of Pulmonary Subsolid Nodules and Degree of invasion Prediction in Pulmonary Adenocarcinoma
摘要
Abstract
Background and objective Subsolid pulmonary nodules are common computed tomography (CT)findings of primary lung adenocarcinoma. It is of clinical value to determine the clinical treatment strategies based on CT fea-tures. The aim of this study is to find the valuable CT characteristics on differential diagnosis and the degree of invasion predic-tion by a retrospectively analysis of three groups subsolid nodules, including benign, and invasive adenocarcinoma. Methods The CT findings of 106 cases of resected sub-solid nodules were retrospectively analyzed. The nodules were firstly divided into benign and malignant groups and the malignant group was further divided into non/micro-invasive group (atypical adeno- matous hyperplasia/adenocarcinoma in situ/minimally invasive adenocarcinoma) and invasive adenocarcinoma group.The nodule size, proportion of solid components, tumor-lung interface, shape, margin, pleural traction, air bronchus sign, vascular abnormalities inside the nodule were evaluated.The univariate analysis (x2test, non-parametric test Mann-Whitney U test) was performed to screen statistically significant variables and then enrolled in further multivariate Logistic regression analysis. Results Multivariate logistic regression analysis showed that a clear tumor-lung interface, air bronchus sign, and pulmonary vascular abnormalities were important indicators of malignant nodules with hazard ratios of 38.1 (95%CI: 5.0-287.7; P＜0.01), 7.9 (95%CI: 1.3-49.3; P=0.03), 7.2 (95%CI: 1.4-37.0; P=0.02), respectively. The proportion of solid components was the only significant indicator for identifying invasive adenocarcinoma from AAH/AIS/MIA , with a risk ratio of 1.04 (95%CI: 1.01-1.06, P=0.01). Conclusion SSNs with clear tumor-lung interface, air bronchus sign, and pulmonary vascular abnormality inside nodule are more likely to be malignant. A higher percentage of solid components indicates a higher likelihood to be an invasive lesion in malignant SPNs.关键词
肺肿瘤/亚实性结节/计算机体层成像/定量变量/定性变量/良性/恶性Key words
Lung neoplasms/Subsolid nodules/Computed tomography/Quantitative variables/Qualitative vari-ables/Benign/Malignant引用本文复制引用
郭芳芳,李欣菱,王欣悦,郑文松,王卿,宋文静,于铁链,范亚光,王颖..亚实性肺结节CT征象在良恶性鉴别及腺癌恶性侵袭程度评估中的价值[J].中国肺癌杂志,2018,21(6):451-457,7.基金项目
本研究受国家自然科学基金面上项目(No.81171345)、天津自然科学基金面上项目(No.17JCYBJC25400)、中央补助地方公共卫生专项资金肺癌早诊早治项目和2012年高等学校博士学科点专项科研基金(No.20121202110005)资助.This study was supported by the grants from the National Natural Science Foundation of China (to Ying WANG)(No.81171345), Natural Science Foundation of Tianjin (to Tielian YU)(No.17JCYBJC25400), Lung Cancer Early Detection and Treatment Project Funded by the Public Health Special Subsidy from the Central Government and Research Fund for the Doctoral Program of Higher Education of China (to Tielian YU)(No.20121202110005). （No.81171345）
