MSCT平扫及强化对周围型肺神经内分泌癌的诊断价值

摘要

目的 探讨多层螺旋CT(MSCT)平扫及强化对周围型肺神经内分泌癌的诊断价值.方法 选择2013年10月至2016年10月间在南海区第七人民医院、汕头大学医学院附属肿瘤医院、广州中医药大学附属佛山中医院3所医院诊治的26例周围型肺神经内分泌癌患者为研究对象,其中类癌(TC)3例,不典型类癌(AC)2例,大细胞神经内分泌癌(LCNEC)8例,小细胞神经内分泌癌(SCLC)13例,观察不同类型周围型肺神经内分泌癌的MSCT特征.结果 各类型周围型肺神经内分泌癌在不同肺叶间分布比较差异无统计学意义(P>0.05).TC、AC、LCNEC及SCLC在最大径[(18.6±5.6)mm vs(22.7±6.9)mm vs(44.5±13.2)mm vs(39.8±12.7)mm]、形态不规则例数(0例vs 0例vs 5例vs 9例)、胸腔积液例数(0例vs 0例vs 6例vs 9例)及区域淋巴结转移例数(0例vs 0例vs 5例vs 10例)间比较差异均具有统计学意义(P<0.05),其中LCNEC及SCLC最大径显著大于TC及AC,形态不规则、胸腔积液及区域淋巴结转移的比例显著高于TC及AC,差异均具有统计学意义(P<0.05).TC、AC、LCNEC及SCLC强化CT值[(93.7±32.7)vs(98.3±37.6)vs(67.5±25.7)vs(74.3±28.5)]及强化差值[(55.6±15.2)vs(58.3±18.4)vs(25.8±9.8)vs(33.1±11.6)]间比较差异均具有统计学意义(P<0.05),且TC及AC强化CT值及强化差值显著高于LCNEC及SCLC,差异均具有统计学意义(P<0.05).结论 MSCT平扫及强化可以为周围型肺神经内分泌癌提供有价值的诊断及鉴别诊断信息.%Objective To investigate the value of MSCT plain scan and enhancement in the diagnosis of pe-ripheral pulmonary neuroendocrine carcinoma. Methods A total of 26 patients with peripheral pulmonary neuroendo-crine carcinoma, who admitted to the Seventh People's Hospital of Nanhai District, the Affiliated Tumor Hospital of Shantou University Medical College, Foshan Chinese Traditional Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine from October 2013 to October 2016 were selected as the research subjects. There were 3 cases of carcinoid tumor (TC), 2 cases of atypical carcinoid tumor (AC), 8 cases of large cell neuroendocrine carcinoma (LCNEC), and 13 cases of small cell neuroendocrine carcinoma (SCLC). The MSCT features of different types of periph-eral pulmonary neuroendocrine carcinoma were observed. Results There was no significant difference in the distribu-tion of different types of peripheral pulmonary neuroendocrine carcinoma between different lung lobes (P>0.05). The largest diameter of TC, AC, LCNEC and SCLC were respectively (18.6 ± 5.6), (22.7 ± 6.9), (44.5 ± 13.2), (39.8 ± 12.7). There were significant differences in the number of morphological irregularity (0 vs 0 vs 5 vs 9), pleural effusion (0 vs 0 vs 6 vs 9) and regional lymph node metastasis (0 vs 0 vs 5 vs 10) among of TC, AC, LCNEC and SCLC (P<0.05). The maxi-mum diameters of LCNEC and SCLC were significantly higher than TC and AC;the proportion of irregular shape, pleu-ral effusion and regional lymph node metastasis were significantly higher than these of TC and AC (P<0.05). The en-hancement CT value and the enhancement different value of TC, AC, LCNEC and SCLC were respectively (93.7±32.7), (98.3±37.6), (67.5±25.7), (74.3±28.5) and (55.6±15.2), (58.3±18.4), (25.8±9.8), (33.1±11.6), with significant differences between the enhancement CT value and the enhancement different value in the four groups, and the enhancement CT val-ue and the enhancement different value of TC and AC were significantly higher than those of LCNEC and SCLC (P<0.05). Conclusion MSCT plain scan and enhancement can provide valuable and differential diagnostic information for peripheral pulmonary neuroendocrine carcinoma.