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目的探讨不同病理组织类型的中央型肺癌的MSCT表现与其对应的纤维支气管镜下表现。方法中央型肺癌200例分鳞癌、腺癌和小细胞肺癌三组,对比各组间MSCT表现及纤维支气管镜的表现。结果 MSCT上肺癌的气道改变在鳞癌与腺癌组、鳞癌与小细胞肺癌组间比较有统计学意义差异。小细胞肺癌组肺门纵隔淋巴结转移率高于其它两组。在纤支镜下,鳞癌主要表现为管内增殖型,腺癌主要为管壁浸润型,小细胞癌也以管壁浸润型为主。结论 MSCT表现对不同组织类型的中央型肺癌有一定的鉴别诊断作用,结合纤支镜所见形态特征可以推测肺癌可能的组织类型。
Objective To investigate the performance of MSCT with different pathological types of central lung cancer and their corresponding bronchoscopic findings. Methods 200 patients with central lung cancer were divided into three groups: squamous cell carcinoma, adenocarcinoma and small cell lung cancer. Comparisons of MSCT findings and fibrobronchoscopy findings among the groups were performed. Results The airway changes of lung cancer in MSCT were statistically different between squamous cell carcinoma and adenocarcinoma group and between squamous cell carcinoma and small cell lung cancer group. The hilar mediastinal lymph node metastasis rate was higher in the small cell lung cancer group than in the other two groups. In bronchoscopy, squamous cell carcinoma is mainly manifested as proliferative tube, adenocarcinoma mainly for infiltration of the wall, small cell carcinoma also infiltrated by the wall-based. Conclusion MSCT has certain differential diagnosis on central lung cancer of different tissue types. The possible types of lung cancer may be speculated based on the morphological features of bronchofibroscopy.