论文部分内容阅读
目的:探讨早期浸润性肺腺癌高分辨率计算机体层x线摄影术(HRCT)的形态学征象与血管、淋巴管浸润的相关性。方法:选择我院2013年9月至2016年5月收治的早期肺腺癌患者共60例,所有研究对象按病灶中有无血管、淋巴管浸润分为浸润组、无浸润组两组,采用单因素和多因素分析筛选CT形态学表现与血管、淋巴管浸润有关的因素,然后进一步对mGGN的实性成分直径及C/T值等运用ROC曲线分析判断其诊断能力。结果:浸润组和无浸润组差异有统计学意义的CT形态学征象包括结节直径、毛刺征、胸膜凹陷征、支气管充气征、血管集束征、静脉受累、病理分类(P<0.05)。其中,毛刺征和静脉受累为血管、淋巴管浸润的独立危险因素(优势比分别为2.737,3.894,P<0.05)。肺结节直径诊断血管、淋巴管浸润的ROC曲线下面积为0.885,而mGGN实性成分直径、C/T值及两者联合检测的ROC曲线下面积分别为0.855,0.801,0.909。结论:早期浸润性肺腺癌HRCT形态学征象中毛刺征和静脉受累为血管、淋巴管浸润的独立危险因素。
Objective: To investigate the correlation between morphologic features of high-resolution computed tomography (HRCT) and vascular and lymphatic invasion in patients with early invasive lung adenocarcinoma. Methods: A total of 60 patients with early stage lung adenocarcinoma admitted to our hospital from September 2013 to May 2016 were enrolled. All subjects were divided into infiltration group and non-infiltration group according to the presence or absence of blood vessels in the lesion, Univariate and multivariate analysis screened CT morphological features and vascular, lymphatic invasion related factors, and then the mGGN real component diameter and C / T value using ROC curve analysis to determine its diagnostic capabilities. Results: There were statistically significant differences in CT morphologic features between the infiltrating group and the non-infiltrating group, including nodule diameter, burr, pleural indentation, bronchial inflatable sign, vascular bundling sign, vein involvement and pathological classification (P <0.05). Among them, burr and vein involvement were independent risk factors for vascular and lymphatic invasion (odds ratios were 2.737 and 3.894, respectively, P <0.05). The area under the ROC curve for the diagnosis of pulmonary nodules with diameter of nodules was 0.885, while the area under the ROC curve of mGGN with solid component diameter, C / T value and their combined detection was 0.855,0.801,0.909. CONCLUSION: Burr and venous involvement in early invasive lung adenocarcinoma morphology are independent risk factors for vascular and lymphatic invasion.