肺磨玻璃结节病理学分级与高分辨率CT征象的相关性分析

摘要

Objective To explore the correlation between pathological grading of groundglass nodules and high resolution CT signs. Methods A total of 127 patients diagnosed as groundglass nodules were selected, and correlation between CT manifestation and pathological grading was analyzed. Results There was no significant difference in age among patients with atypical adenomatoid hyperplasia (AAH), adherent adenocarcinoma in situ (AIS) growing completely along alveolar septum, microinvasive adenocarcinoma (MIA) and invasive adenocarcinoma (IA) (P＞ 0. 05). There was no significant difference in gender among AAH group, AIS group and MIA group (P＞ 0. 05), but there were significant differences between IA group and AAH group, AIS group (P ＜ 0. 05). There was no significant difference in the incidence rate of burr sign between IA group and MIA group (P＞0. 05), but both were significantly higher than AIS group and AAH group (P ＜ 0. 05), and the incidence rate of burr sign in AIS group was significantly higher than that in AAH group (P ＜ 0. 05).There was no significant difference in the incidence rate of leaf sign among AAH group, AIS group and MIA group (P＞ 0. 05), but the incidence rate of leaf sign in IA group was significantly higher than that in AAH group, AIS group and MIA group (P ＜ 0. 05). There was no significant difference in the incidence rate of vacuole sign among AAH group, AIS group and MIA group (P＞ 0. 05), but the incidence rate of vacuole sign in IA group was significantly higher than that in AAHgroup, AIS group and MIA group (P ＜ 0. 05). The incidence rate of bronchial inflation sign in AIS group, MIA group and IA group was significantly higher than that in AAH group (P ＜ 0. 05), and which in IA group was significantly higher than that in AIS group (P ＜ 0. 05), but there was no significant difference between MIA group and IA group (P＞ 0. 05). The incidence rate of pleural indentation in IA group was significantly higher than that in AAH group, AIS group and MIA group (P ＜ 0. 05), and which in MIA group was significantly higher than that in AAH group (P ＜ 0. 05), but there was no significant difference between MIA group and AIS group (P＞ 0. 05). Conclusion Burr sign, lobulation sign, vacuole sign, bronchial pneumatic sign and pleural indentation sign are the important basis for differentiating pathological grading of ground-glass nodules. The analysis of CT imaging features of ground-glass nodules is helpful for differentiating pathological grading.%目的 探讨肺磨玻璃结节病理学分级与高分辨率CT征象的相关性.方法 选取病理诊断为肺部磨玻璃结节患者127例,分析患者的CT表现与病理性分级的相关性.结果 非典型腺瘤样增生(AAH)、完全沿肺泡间隔贴壁样生长的原位腺癌(AIS)、微浸润腺癌(MIA)、浸润性腺癌(IA)组患者年龄比较,差异无统计学意义(P＞ 0.05);AAH、AIS、MIA组性别比较,差异无统计学意义(P＞ 0.05),IA组与AAH、AIS组性别相比较,差异有统计学意义(P ＜0.05).IA组与MIA组毛刺征发生率差异无统计学意义(P＞ 0.05),但均显著高于AIS组、AAH组(P ＜0.05),且AIS组毛刺征发生率显著高于AAH组(P ＜0.05).AAH、AIS、MIA组分叶征发生率比较,差异均无统计学意义(P＞ 0.05),IA组分叶征发生率显著高于AAH、AIS与MIA组(P ＜0.05).AAH、AIS、MIA组空泡征发生率比较差异无统计学意义(P＞ 0.05),IA组空泡征发生率显著高于AAH、AIS和MIA组(P ＜0.05).AIS、MIA、IA组支气管充气征发生率显著高于AAH组(P ＜0.05),IA组显著高于AIS组(P ＜0.05),MIA组与IA组比较差异无统计学意义(P＞ 0.05).IA组胸膜凹陷征发生率显著高于AAH、AIS、MIA组(P ＜0.05),MIA组胸膜凹陷征发生率显著高于AAH组(P ＜0.05),MIA组与AIS组胸膜凹陷征发生率比较差异无统计学意义(P＞ 0.05).结论 毛刺征、分叶征、空泡征、支气管充气征、胸膜凹陷征是鉴别肺磨玻璃结节病理学分级的重要依据,对磨玻璃结节的CT影像学特征进行分析有利于病理学分级的鉴别.