目的:通过对38例周围型肺癌早期X线征象的分析,探讨早期X线诊断标准。材料与方法:对38例早期周围型肺癌(腺癌24例,鳞癌8例,小细胞癌6例;伴纵隔淋巴结转移12例、脑转移6例)的X线分析,以利提高诊断水平。结果:38例早期周围型肺癌的病灶直径1.1cm～4.8cm,平均为1.65cm,据其形态分为3个类型:(1)小结节型25例(26个病灶),病灶密度中等偏低,有细小毛刺征15例,浅分叶征11例、胸膜凹陷征7例、小泡征5例及钙化斑点1例;(2)小斑型7例,病灶边缘模糊似星芒状,形态不规则;(3)小空洞型6例,呈中心性厚壁空洞4例,呈灶性小空洞2例。所有病灶外围均无卫星病灶。结论:肺内≤2cm的孤立结节、斑片状或空洞阴影,形态不规则,灶内有小泡征,边缘有浅分叶征、细小毛刺征等均考虑肺癌且以腺癌可能性大;注意与肺内常见结节鉴别;定性确有困难者可选择CT扫描,采用X线动态观察,但时间不宜超过3个月;必要时选择痰检、肺穿刺活检、或手术治疗。 Objective: To analyze the early X-ray findings of 38 cases of peripheral lung cancer to explore the diagnostic criteria of early X-ray. Materials and Methods: X-ray analysis of 38 cases of early stage peripheral lung cancer (24 cases of adenocarcinoma, 8 cases of squamous cell carcinoma, 6 cases of small cell carcinoma, 12 cases of mediastinal lymph node metastasis and 6 cases of brain metastasis) . Results: The diameter of 38 cases of early-stage peripheral lung cancer was 1.1cm ~ 4.8cm in diameter, with an average of 1.65cm. There were 3 types according to their morphology: (1) 25 cases of nodules (26 lesions) There were 15 cases of small burr, 11 cases of shallow lobulation, 7 cases of pleural indentation, 5 cases of vesicle sign and 1 case of calcified plaque. (2) Small plaque in 7 cases, Irregular shape; (3) 6 cases of small cavities, central thick-walled hollow in 4 cases, showed focal small voids in 2 cases. No satellite lesions on the periphery of all lesions. CONCLUSION: Isolated nodules with less than 2 cm in the lung, patchy or empty shadow, irregular shape, small vesicle sign in the stovepipe, shallow lobes on the margin, small burr signs and so on are all considered for lung cancer and the possibility of adenocarcinoma ; Attention and identification of common pulmonary nodules; qualitative indeed difficult to choose CT scan, the use of X-ray dynamic observation, but the time should not exceed 3 months; if necessary, select the sputum examination, lung biopsy, or surgical treatment.