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目的探讨肿瘤倍增时间(DT)在肺内磨玻璃结节(GGNs)中的应用价值。方法回顾性分析2008年9月至2015年12月在华东医院诊治的78例肺内GGNs的影像学资料,结节均经手术切除,术后病理证实为微浸润性腺癌(MIA)和浸润性腺癌(IAC)。根据密度差异将初诊结节分为纯磨玻璃结节(pGGN)及混合性磨玻璃结节(mGGN),采用体积倍增时间(VDT)计算,不同类型结节的DT具有统计学差异。结果 78例GGNs中共有pGGN40例,mGGN 38例,术后病理:MIA 38例,IAC 40例。pGGN的平均DT为845天,mGGN的平均DT为538天,使用独立样本t检验,两者差异具有统计学意义(P<0.05)。设定DT≤730天、1095天、1460天,分别作为MIA和IAC的诊断阈值,pGGN诊断为MIA敏感性分别为67%、78%、73%,特异性33%、50%、29%,准确性50%、60%、56%。设定DT≤365天、730天、1095天,分别作为MIA和IAC的诊断阈值,mGGN诊断为MIA敏感性分别为25%、27%、24%,特异性50%、88%、89%,准确性33%、59%、58%。结论 mGGN较pGGN增长快速,随访中应缩短随访间隔及随访时间;初诊为pGGN时,以DT≤1095天作为手术点有较高的价值;初诊为mGGN时,以DT≤730天作为手术点有较高的价值。
Objective To investigate the value of tumor doubling time (DT) in ground pulmonary nodules (GGNs). Methods The imaging data of 78 cases of lung GGNs diagnosed and treated in East China Hospital from September 2008 to December 2015 were retrospectively analyzed. All the nodules were resected surgically. Pathological examination confirmed that microinvasive adenocarcinoma (MIA) and infiltrating gonads Cancer (IAC). According to the difference of density, newly diagnosed nodules were divided into purely ground glass nodules (pGGN) and mixed ground glass nodules (mGGN), and the volume doubling time (VDT) was used to calculate the DT of different types of nodules. Results There were 40 cases of pGGN and 38 cases of mGGN in 78 GGNs. There were 38 cases of MIA and 40 cases of IAC after operation. The average DT of pGGN was 845 days, and the average DT of mGGN was 538 days, using the independent sample t-test, the difference was statistically significant (P <0.05). The diagnostic thresholds of MIA and IAC were set at DT≤730 days, 1095 days and 1460 days, respectively. The diagnostic sensitivity of pGGN for MIA was 67%, 78%, 73%, specificity 33%, 50%, 29% Accuracy 50%, 60%, 56%. Set DT≤365 days, 730 days and 1095 days respectively as the diagnostic threshold of MIA and IAC. The sensitivity of mGGN to MIA was 25%, 27%, 24%, 50%, 88%, 89% Accuracy 33%, 59%, 58%. Conclusion The mGGN increased more rapidly than pGGN. The follow-up interval should be shortened and follow-up time should be shortened. When pGGN was newly diagnosed, the value of DT≤1095 days was considered as the operative point. When mGGN was newly diagnosed, DT≤730 days Higher value.