Abstract:Objective: To evaluate the diagnostic value of HRCT signs of pure ground glass nodules (pGGN) in non-lepidic invasive lung adenocarcinoma (IAC), and to find the optimal imaging indicator. Methods: The clinical data of 85 patients with IAC confirmed by surgical pathology and HRCT imaging data of 86 pGGNs were retrospectively analyzed. According to the pathology, they were divided into lepidic dominant group (48 cases, 47 patients) and non-lepidic dominant group (38 cases, 38 patients). The HRCT signs such as mean CT value, maximum diameter, burrs sign, abnormal vascular sign and abnormal bronchial sign were compared between the two groups. The ROC curve was analyzed with non-lepidic dominant adenocarcinoma as the dependent variable, and the area under the curve (AUC) was used to evaluate the diagnositic efficacy of each imaging indicator. Results: The mean CT value and maximum diameter of non-lepidic dominant IAC were higher than lepidic dominant IAC. The incidence of abnormal vascular sign, abnormal bronchial sign and burrs sign of non-lepidic dominant IAC was higher than lepidic dominant IAC (P<0.05). ROC curve analysis showed that the area under the curve of non-lepidic dominant IAC was 0.877,the efficiency was 0.895,the sensitivity was 0.729, and its diagnostic efficiency was higher than other indicators. Conclusion: The mean CT value has a high diagnositic value for non-lepidic dominant IAC with pGGN and is the optimal imaging indicator.
[1] 余烨,张莹,张凤,等.CT征象对pGGN样肺腺癌浸润性的诊断价值[J].国际医学放射学杂志,2020,43(6):639-643. [2] 张磊,谢晓东,沈文荣,等.CT征象在预测肺纯磨玻璃结节侵袭风险中的价值[J].实用放射学杂志,2020,36(2):207-210,213. [3] Travis WD,Brambilla E,Nicholson AG,et al.The 2015 world health organization classification of lung tumors:impact of genetic,clinical and radiologic advances since the 2004 classification[J].Journal Thoracic Oncology,2015.10(9):1243-1260. [4] 李媛,谢惠康,武春燕.WHO胸部肿瘤分类(第5版)中肺肿瘤部分解读[J].中国癌症杂志,2021,31(7):574-580. [5] 中华医学会肿瘤学分会,中华医学会杂志社.中华医学会肿瘤学分会肺癌临床诊疗指南(2021版)[J].中华医学杂志,2021,101(23):1725-1757. [6] 彭晞,符立辉,黄鹏达.磨玻璃结节样多灶性肺腺癌CT征象与分化程度和淋巴结转移的关系[J].河北医学,2022,28(3):407-412. [7] Chu ZG,Li WJ,Fu BJ,et al.CT characteristics for predicting invasiveness in pulmonary pure ground-glass nodules[J].AJR Am J Roentgenol,2020,15(2):351-358. [8] Ichinose J,Kawaguchi Y,Nakao M,et al.Utility of maximum CT value in predicting the invasiveness of pure ground-glass nodules[J].Clin Lung Cancer,2020,21(3):281-287. [9] 赵鎏,刘馨,杜思瑶,等.定量诊断模型对表现为磨玻璃密度结节浸润性肺腺癌的诊断[J].中国临床医学影像杂志,2020,31(7):474-477. [10] 顾鑫蕾,刘展,邵为朋,等.肺结节CT特征对腺癌病理亚型的预测价值[J].中国胸心血管外科临床杂志,2022,06(29):684-692. [11] 张鹏举,李天然,陶雪敏,等.磨玻璃结节早期贴壁生长为主型浸润性肺腺癌与其他病理亚型的CT特征分析[J].中华放射学杂志,2021,55(7):739-744. [12] 刘芯言.肺纯磨玻璃结节浸润性腺癌的CT特征判定贴壁成分占比的初步研究[D].大连:大连医科大学,2019. [13] 黎佳维,伍建林,李凤.贴壁型与非贴壁型肺腺癌的HRCT表现及鉴别诊断[J].湖北科技学院学报:医学版,2018,32(3):4. [14] 肖瑜,杨娅,蒋锐,等.亚实性肺结节CT征象与肺腺癌浸润程度及其组织学亚型关系分析[J].生物医学工程与临床,2022,26(1):40-44.