周围型小肺癌 CT 密度差异分型及其临床意义

摘要

To evaluate the correlation between the CT claasflication of small peripheral lung cancer according to ground glass opacity and its clinical application. Methods Totally 116 patients with small peripheral lung cancer were studied. The pathological features were analyzed according to four types of GGO contains on CT imagines. Results GGO ? type contained 90% - 100 % type (n = 33) , of which 32 patients had BAC, 1 patients had well differentiated adenocarcinoma. GGO ? type contained 50% - 89% type (n = 29), of which 17 patients had BAC,four patients had well differentiated adenocarcinoma accompany BCA.5 patients had well differentiated adenocarcinoma,3 patients had moderately differentiated adenocarcinoma. GGO ? type contained 10% ~49% type (n =28), of which 8 patients had BCA,four patients had well differentiated adenocarcinoma accompany BCA,9 patients had moderately differentiated adenocarcinoma,4 patients had poorly differentiated adenocarcinoma, 3 patients had poorly differentiated squamocarcinoma. GGO ? type contained less than 10% type (n =26) ,of which 3 patients had BCA.4 patients had well differentiated adenocarcinoma accompany BCA.5 patients had moderately differentiated adenocarcinoma,8 patients had poorly differentiated adenocarcinoma, 3 patients had papillary adenocarcino-ma,3 patients had small cell lung cancer. We also found the higher GGO contains, the better pathological type lung cancer is. Conclusion Focal area of ground glass is not only prognosis the type of pathology but also the directions of therapeutic principle.%目的 根据周围型小肺癌的密度差异做CT分型并探讨其临床意义.方法 搜集资料完整的周围型小肺癌116个,根据其CT图上有无磨玻璃密度(ground glass opacity,GGO)及其占整个病灶比例的不同分4型,并与病理结果对照.结果 116个周围型小肺癌中Ⅰ型(GGO成分占90％ ～ 100％)33个,细支气管肺泡癌(BAC)32个,高分化腺癌1个；Ⅱ型(GGO成分占50％～89％)29个,BAC17个,BAC伴高分化腺癌4个,高分化腺癌5个,中分化腺癌3个；Ⅲ型(GGO成分占10％～49％)28个,BAC8个,BAC伴高中分化腺癌4个,中分化腺癌9个,低分化腺癌4个,低分化鳞癌3个；Ⅳ型(GGO成分＜10％)26个,BAC3个,BAC伴高中分化腺癌4个,中分化腺癌5个,低分化腺癌8个,乳头状腺癌3个,小细胞肺癌3个；通过4型间比较发现GGO所占比例越高,小肺癌的病理分化越好,Ⅰ型病理绝大多数为BAC(32/33),Ⅱ型病理多数为BAC(17/29),而Ⅲ型、Ⅳ型中仅少数为BAC(11/54).结论 根据周围型小肺癌的密度差异做分型,能一定程度上预测其病理类型及预后,并指导处理原则.