高分辨率CT肺纯磨玻璃结节影像征象对其侵袭性的预测价值

李凤; 薛昌辉; 黄洪磊; 吴志涛; 阙瑞华; 陈晓燕; 李琦

doi:10.19732/j.cnki.2096-6210.2019.06.008

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高分辨率CT肺纯磨玻璃结节影像征象对其侵袭性的预测价值

论著 | 更新时间：2025-12-15

- 高分辨率CT肺纯磨玻璃结节影像征象对其侵袭性的预测价值
- Predictive value of high resolution CT for pathological subtypes of lung adenocarcinoma with pure ground- glass nodule
- 肿瘤影像学 2019年28卷第6期页码：394-399
- 作者机构：
- 作者简介：
- 基金信息：
  
  福建医科大学启航基金（2018QH1181）。
- DOI：10.19732/j.cnki.2096-6210.2019.06.008
  中图分类号：
- 网络出版：2019-12-28，
  
  纸质出版：2019-12-28
- 稿件说明：
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李凤,薛昌辉,黄洪磊,等. 高分辨率CT肺纯磨玻璃结节影像征象对其侵袭性的预测价值[J]. 肿瘤影像学, 2019, 28(6): 394-399 https://doi.

org/10.19732/j.cnki.2096-6210.2019.06.008
李凤,薛昌辉,黄洪磊,等. 高分辨率CT肺纯磨玻璃结节影像征象对其侵袭性的预测价值[J]. 肿瘤影像学, 2019, 28(6): 394-399 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.06.008.

org/10.19732/j.cnki.2096-6210.2019.06.008 DOI：

摘要

目的：

探讨高分辨率CT（high resolution CT，HRCT）肺纯磨玻璃结节（pure ground-glass nodule，pGGN）影像表现与肺腺癌病理学亚型之间的相关性，评估HRCT对pGGN肺腺癌病理学亚型的预测价值。

方法：

回顾并分析福建省南平市第一医院经手术及病理学检查证实的90例pGGN患者临床资料，观察的影像学征象包括病灶位置、薄层CT图像上的最大径、病灶边缘、病灶内部（空泡征、空气支气管征）、血管改变及瘤肺界面。

结果：

pGGN的分叶、空泡、空气支气管、血管改变、瘤肺界面在3种病理学亚型间（浸润前病变组、微浸润病变组、浸润性病变组）差异有统计学意义（

值分别为34.939、10.355、6.503、66.031、11.911；

均＜0.05），但各病理学亚型间的病变部位、毛刺、胸膜凹陷征等特征差异无统计学意义（

值分别为5.230、3.413、3.211；

均＞0.05）。3组pGGN病灶的直径大小，浸润性病变组［（17.88.9）mm］＞微浸润病变组［（11.55.5）mm］＞浸润前病变组［（9.43.4）mm］，差异有统计学意义（

=17.535，

＜0.05），其中浸润性病变组病灶大小与浸润前病变组、微浸润病变组比较，差异均有统计学意义（

＜0.01），而浸润前病变组和微浸润病变组之间病灶大小差异无统计学意义（

=0.172）。受试者工作特征（receiver operating characteristic，ROC）曲线分析显示，肺腺癌微浸润病变组与浸润性病变组病灶直径的最佳阈值为1.38 cm，诊断的灵敏度、特异度分别为80.8%、81.8%，曲线下面积为0.762。

结论：

pGGN的HRCT征象对评估其侵袭程度可提供重要指导，其中病灶大小、分叶、空泡、空气支气管、血管改变和瘤肺界面对肺腺癌侵袭程度的鉴别具有一定的诊断价值。

Abstract

Objective:

To explore the correlation between high resolution CT (HRCT) imaging findings o

f pure ground-glass nodules (pGGN) and pathological subtypes of lung adenocarcinoma

and to evaluate the predictive value of HRCT for pathological subtypes of lung adenocarcinoma with pGGN.

Methods:

Retrospective analysis of 90 patients with pGGN confirmed by surgery and pathology in Nanping First Hospital of Fujian. The imaging signs were observed

including the location and size of the lesion (maximum diameter on the thin-slice CT image)

the edge of the lesion

internal signs of focus (cavitation sign

air bronchus sign)

vascular changes and the tumor-lung interface.

Results:

The lobulation

vacuolization

air bronchus

vascular changes

and tumor-lung interface of pGGN were statistically significant among the three pathological subtypes (

=34.939

10.355

6.503

66.031

11.911;

＜0.05). However

the lesions

burrs

and pleural indentations between the pathological subtypes were not statistically significant (

=5.230

3.413

3.211;

＞0.05). Among the three groups of pGGN lesions

the invasive lesion group ［(17.88.9) mm］＞ microinvasive lesion group ［(11.55.5) mm］＞ pre-invasive lesion group ［(9.43.4) mm］

the difference was statistical significance (

=17.535;

＜0.05). There were significant differences in the size of the lesions between the invasive adenocarcinoma group and the pre-invasion group or micro-invasion group (

＜0.01)

but there was no significant difference between the pre-invasiongroup and micro-invasion group (

=0.172). The optimal threshold of the size of the lung infiltrating group and the invasive group was 1.38 cm

and the sensitivity and specificity of the diagnosis were 80.8% and 81.8% respectively. The area under the curve was 0.762.

Conclusion:

The HRCT signs of pGGN in the lung can provide important guidance for assessing the degree of invasion. The lesion size

lobulation

vacuolization

air bronchus

vascular changes

and the tumo

r-lung interface of lung and lung adenocarcinoma have certain diagnosis value.

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