超高分辨率CT(UHRCT)鉴别肺原位腺癌(AIS)与微浸润腺癌(MIA)

肖时满1▲,张玉1▲,强金伟1△,叶剑定2

复旦学报(医学版) ›› 2014, Vol. 41 ›› Issue (03) : 285-290.

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复旦学报(医学版) ›› 2014, Vol. 41 ›› Issue (03) : 285-290. DOI: 10.3969/j.issn.16728467.2014.03.001
论著

超高分辨率CT(UHRCT)鉴别肺原位腺癌(AIS)与微浸润腺癌(MIA)

  • 肖时满1▲,张玉1▲,强金伟1△,叶剑定2
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Ultra-high-resolution computed tomography (UHRCT) in differentiating between lung adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA)

  • XIAO Shi-man1▲, ZHANG Yu1▲, QIANG Jin-wei1△, YE Jian-ding2
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摘要

目的  分析早期肺腺癌的超高分辨率CT(ultra-high-resolution computed tomography,UHRCT)表现,探讨UHRCT鉴别肺原位腺癌(adenocarcinoma in situ,AIS)与微浸润癌(minimally invasive adenocarcinoma,MIA)的价值。方法   回顾性分析经手术和病理证实、直径小于2 cm的早期肺腺癌结节(AIS 67个,MIA 62个)的UHRCT表现,分析和比较AIS与MIA在结节的形状、边缘、密度、直径、内部实性成分直径、血管异常、空气支气管征、空泡征、胸膜凹陷征以及是否多发等方面的差异。结果  两组结节在形状、边缘、密度、直径、实性成分直径和密度、肺静脉异常、空气支气管征和胸膜凹陷征上的差异均有统计学意义(P<0.05)。AIS常表现为较小的圆形或类圆形的纯磨玻璃结节(groundglass nodule,GGN),MIA常为较大、边缘毛刺、实性成分直径大于5 mm 的混合GGN,并常伴肺静脉异常、支气管扩张和胸膜凹陷征。结论  UHRCT能显示早期肺腺癌的形态学特征,有助于鉴别肺AIS与MIA。

Abstract

Objective  To analyze ultra-high-resolution computed tomography (UHRCT) appearances of early lung adenocarcinoma and to evaluate UHRCT in the differentiation of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA).Methods  UHRCT appearances of 129 nodules (less than 2 cm in diameter) of early lung adenocarcinoma were reviewed retrospectively.All these nodules (67 nodules of AIS and 62 nodules of MIA) were proven by surgery and pathology.UHRCT features of lung nodules in the two groups,including the shape,margin,density,diameter,diameter of internal solid component,vascular changes,air bronchogram,vacuole,pleural indentation and multiplicity,were analyzed and compared.Results  Statistically significant differences were
 found in shape,margin,density,diameter,diameter and density of internal solid component,pulmonary vein changes,air bronchogram and pleural indentation (all P<0.05),respectively.AIS frequently appeared as a small,well-defined,round or oval,pure groundglass nodule (GGN).In contrast,MIA was more often a larger,spiculated margin,mixed GGN with an internal solid component larger than 5 mm.In addition,MIA often had abnormal pulmonary vein,air bronchogram and pleural indentation.Conclusions  UHRCT can demonstrate the morphological features of early lung adenocarcinoma and discriminate between AIS and MIA.

关键词

CT / 高分辨率 / 肺癌 / 原位腺癌(AIS) / 微浸润腺癌(MIA)

Key words

computed tomography (CT) / high resolution / lung cancer / adenocarcinoma in situ (AIS) / minimally invasive adenocarcinoma (MIA)

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导出引用
肖时满1▲,张玉1▲,强金伟1△,叶剑定2. 超高分辨率CT(UHRCT)鉴别肺原位腺癌(AIS)与微浸润腺癌(MIA)[J]. 复旦学报(医学版), 2014, 41(03): 285-290 https://doi.org/10.3969/j.issn.16728467.2014.03.001
XIAO Shi-man1▲, ZHANG Yu1▲, QIANG Jin-wei1△, YE Jian-ding2. Ultra-high-resolution computed tomography (UHRCT) in differentiating between lung adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA)[J]. Fudan University Journal of Medical Sciences, 2014, 41(03): 285-290 https://doi.org/10.3969/j.issn.16728467.2014.03.001

基金

国家自然科学基金(81171340); 上海市科委临床重点项目(10411956800)

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