| 康柳青,黎海亮,张孝先,吴越,陈学军.磨玻璃密度肺腺癌内血管异常CT表现与病理亚型及磨玻璃分型的相关性[J].中国医学影像技术,2018,34(4):548~552 |
| 磨玻璃密度肺腺癌内血管异常CT表现与病理亚型及磨玻璃分型的相关性 |
| Correlation between CT manifestations of intramural vascular abnormalities and pathological subtypes, ground glass types in ground-glass opacity lung adenocarcinoma |
| 投稿时间：2017-07-14 修订日期：2018-03-05 |
| DOI：10.13929/j.1003-3289.201707059 |
| 中文关键词: 肺肿瘤 腺癌 病理学 体层摄影术,X线计算机 |
| 英文关键词:Lung neoplasms Adenocarcinoma Pathology Tomography,X-ray computed |
| 基金项目:国家自然科学基金（81372370）。 |
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| 中文摘要: |
| 目的 分析磨玻璃密度（GGO）肺腺癌血管异常CT表现与病理亚型及磨玻璃分型的相关性。方法 收集经手术病理证实的50例GGO密度肺腺癌患者的影像学及病理资料，观察病灶内血管的走行及其异常表现（增粗、增多），分析血管异常表现与病灶的病理亚型及磨玻璃分型的相关性。结果 共55个GGO肺腺癌病灶，浸润前病变5个，均无血管增粗，1个原位癌病灶仅出现血管增多；微浸润腺癌（MIA）16个，11个出现血管增粗，16个血管增多；浸润腺癌（IAC）34个，均有血管增粗及增多。浸润前病变、MIA、IAC 3个病理亚型血管增粗、血管增多的整体差异均有统计学意义（χ2=27.67、20.08，P均<0.05），且病理亚型与血管增粗和血管增多均存在相关性（r=0.61、0.66，P均<0.01）。两两比较，浸润前病变、MIA、IAC血管增粗差异均有统计学意义（浸润前病变与MIA：χ2=9.19，P=0.01；浸润前病变与IAC：χ2=29.87，P<0.01；MIA与IAC：χ2=12.63，P<0.01）。两两比较，浸润前病变与MIA、浸润前病变与IAC血管增多差异均有统计学意义（χ2=15.45、20.79，P均<0.01）。55个GGO肺腺癌病灶中，25个为纯GGO（pGGO），出现血管增粗17个，血管增多21个；30个为混杂GGO（mGGO），出现血管增粗28个，血管增多30个。pGGO和mGGO肺腺癌血管增粗和血管增多的差异均有统计学意义（χ2=6.12、6.69，P均<0.05）。结论 GGO肺腺癌血管增粗及增多提示病变浸润性增加，血管增粗及增多均可单独出现。 |
| 英文摘要: |
| Objective To investigate the correlation between CT manifestations of intramural vascular abnormalities and pathological subtypes, ground glass types in ground-glass opacity (GGO) lung adenocarcinoma. Methods CT data of 50 patients (55 lesions) with GGO lung adenocarcinoma confirmed by operative pathology were analyzed. The vascular morphology was observed. Correlation between vascular abnormalities (vascular thickening and hyperplasia) and pathological subtypes, ground glass types in GGO lung adenocarcinoma were analyzed. Results Among 55 GGO lung adenocarcinoma lesions, 5 were pre-invasive lesions, no vascular thickening was observed, whereas vascular increasing was noticed in 1 lesion. Among 16 minimally invasive adenocarcinomas (MIA), vascular thickening and vascular increasing were observed in 11 and 16 lesions, respectively. All 34 invasive adenocarcinomas (IAC) were found with vascular thickening and increasing. The overall difference of vascular thickening and vascular increasing among pre-invasive lesions, MIA and IAC was statistically significant (χ2=27.67, 20.08, both P<0.05). There was positive correlation between pathological subtypes and vascular thickening and vascular increasing (r=0.61, 0.66, P<0.01). Significant differences of vascular thickening were found between pre-invasive lesions and MIA (χ2=9.19, P=0.01), pre-invasive lesions and IAC (χ2=29.87, P<0.01), as well as MIA and IAC (χ2=12.63, P<0.01). There were significant differences of vascular increasing between pre-invasive lesions and MIA, pre-invasive lesions and IAC (χ2=15.45, 20.79, both P<0.01). Of all 55 GGO lung adenocarcinoma lesions, 25 were pGGO, 17 with vascular thickening and 21 vascular increasing; 30 were mGGO, 28 with vascular thickening and 30 vascular increasing. There were significant differences of vascular thickening and increasing in pGGO and mGGO (χ2=6.12, 6.69, both P<0.05). Conclusion Vascular abnormalities in GGO lung adenocarcinoma suggest increasing of invasion. Vascular thickening and increasing can occur independently. |
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