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[目的]探讨平扫CT值对表现为纯磨玻璃密度的肺原位腺癌(AIS)和微浸润腺癌(MIA)的鉴别诊断价值。[方法 ]回顾性分析表现为纯磨玻璃密度的肺原位腺癌32例、微浸润腺癌45例的术前资料,比较两组病例平扫CT值,并通过ROC曲线确定两组病例CT值的最佳截断点。[结果]原位腺癌与微浸润腺癌的CT值不同(-595.37±79.49Hu vs-497.62±121.08Hu;Z=-3.406,P<0.05),CT值对于原位腺癌与微浸润腺癌的诊断价值较好(曲线下面积0.729,95%CI:0.618~0.839,P<0.05),-491.55Hu为AIS与MIA的最佳CT值截断点(灵敏度为48.9%,特异性为93.7%)。[结论]平扫CT值对于肺原位腺癌和微浸润腺癌的诊断有一定指导意义,当CT值>-491.55Hu时,病灶为MIA可能性大;当CT值<-491.55Hu时,病灶为AIS可能性大。
[Objective] To evaluate the value of plain CT in differential diagnosis of lung adenocarcinoma of the lung (AIS) and micro-invasive adenocarcinoma (MIA) with pure glass density. [Methods] The preoperative data of 32 cases of lung adenocarcinoma in situ and 45 cases of micro-invasive adenocarcinoma were retrospectively analyzed. The CT values of the two groups were compared. The ROC curve was used to determine the CT The best value of the cut-off point. [Results] The CT values of in situ adenocarcinoma and micro-infiltrating adenocarcinoma were different (-595.37 ± 79.49Hu vs -497.62 ± 121.08Hu; Z = -3.406, P <0.05) The diagnostic value of cancer was better (area under the curve 0.729,95% CI: 0.618-0.839, P <0.05), 491.55Hu was the best CT cutoff point of AIS and MIA (sensitivity 48.9%, specificity 93.7% ). [Conclusion] The CT value of plain scan has some guiding significance for the diagnosis of adenocarcinoma of the lung and micro-invasive adenocarcinoma. When the CT value is -491.55Hu, the possibility of MIA is high. When the CT value is <-491.55Hu, Lesions are likely to be AIS.