周围型空洞性肺鳞癌与腺癌的影像学比较研究

摘要

Objective To analyze the CT features of cavitation between primary lung adenocarcinoma and squamous cell cancer.Methods The CT findings of cavity of primary lung adenocarcinoma and squamous cell carcinoma were evaluated in 57 patients,including 33 of squamous cell carcinoma and 24 of adenocarcinoma.The clinical data and CT features were analyzed retrospectively using the independent samples t-test,Pearson Chi-square test or Fisher's exact test.Results The mean age of ptients with squamous cell carcinoma was higher than that of patients with adenocarcinoma (65.57-4-9.26 vs 58.75 ± 11.12,P =0.015).Statistical differences were found in distribution of gender and smoking habit between the two kinds of carcinomas (P =0.014 and P =0.029).The T stages were also different between the two carcinomas (P=0.003).In addition,the maximum diameter of tumor (P =0.003),the maximum diameter of cavity (P =0.029) and the maximum thickness of the cavity wall (P=0.001) of squamous cell carcinoma were higher than those of adenocarcinoma.Moreover,the presence of ground-glass opacity (P =0.010),vessel passing through the cavity (P =0.001),septum inside the cavity (P＜0.001) and tumoral bronchogram (P =0.027) in adenocarcinoma were higher than those in squamous cell carcinoma.Conclusion There are significant differences between adenocarcinoma and squamous cell carcinoma in the population distribution and image features,comprehensive analysis helps the differential diagnosis.%目的 分析周围型空洞性肺腺癌及肺鳞癌的CT表现特点.方法 回顾性分析57例经病理证实的伴有空洞形成的33例肺鳞癌及24例肺腺癌患者的一般资料及CT影像表现,并对2组数据进行比较.计量资料采用两独立样本t检验,2组病变T分期及CT征象组间比较采用Pearson x 2检验或Fisher确切概率法进行统计分析.结果 (1)周围型空洞性肺鳞癌组平均发病年龄(65.57±9.26)岁高于空洞性肺腺癌组(58.75±11.12)岁,P=0.015.(2)空洞性肺鳞癌组以男性发病居多(87.8％),腺癌则以女性患者居多(41.7％),P=0.014.空洞性肺鳞癌患者中有吸烟史比例(72.4％)明显高于空洞性肺腺癌组(41.7％),P=0.029.(3)2组病变T分期存在明显统计学差异(P =0.003).(4)鳞癌空洞组与腺癌空洞组在肿瘤最大径、空洞最大径及洞壁厚度最大径方面均存在明显差异(P=0.003,P=0.029,P=0.001).鳞癌空洞病灶一般较大,壁厚.肺腺癌空洞组中薄壁空洞发生比例(41.7％)明显高于肺鳞癌空洞组(9.1％),P=0.004.(5)空洞内部及周围CT征象的差别在2组病变鉴别中最为重要,肺腺癌空洞组在空洞内间隔显示(P＜0.001)、病灶内充气支气管征(P=0.027)及病灶内血管穿行征显示(P =0.001)、空洞病灶周围磨玻璃密度影显示(P=0.010)方面高于肺鳞癌空洞组.结论 周围型空洞性肺鳞癌与空洞性肺腺癌在人群分布、影像特征上存在一定差异,综合分析有助于两者的鉴别.