| 周丽娜,吴宁.同时多原发肺腺癌的CT表现与病理对照[J].中国医学影像技术,2012,28(4):676~679 |
| 同时多原发肺腺癌的CT表现与病理对照 |
| Imaging features of synchronous multiple primary lung adenocarcinomas on CT: Comparison with histopathology |
| 投稿时间：2011-09-21 修订日期：2011-10-28 |
| DOI： |
| 中文关键词: 肺肿瘤 肿瘤,多原发 体层摄影术,X线计算机 病理学 |
| 英文关键词:Lung neoplasms Neoplasms, multiple primary Tomography, X-ray computed Pathology |
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| 中文摘要: |
| 目的 探讨同时多原发肺腺癌的CT表现。方法 回顾性分析经手术病理证实的29例同时多原发肺腺癌的61个病灶的CT表现和组织病理学检查结果,对二者进行对照观察。结果 同时多原发肺腺癌同侧肺发生率(27/29,93.10%)高于双侧肺(2/29,6.90%),同侧不同肺叶发生率(20/27,74.07%)高于相同肺叶(7/27,25.93%);双原发肺腺癌发生率(28/29,96.55%)高于多原发肺腺癌(1/29,3.45%)。本组中分化腺癌占首位(30/61,49.18%);同一患者同时多发癌灶的影像学表现(大小、密度、毛刺、空洞、支气管征、胸膜牵拉)无完全相同者。≤1.5 cm病灶中,以高分化腺癌占首位(13/30,43.33%);1.6~3.0 cm病灶以中分化腺癌多见(18/24,75.00%);>3.0 cm病灶中,低分化腺癌占首位(3/7,42.86%)。在薄层CT图像显示的非实性结节中,高分化腺癌占54.55%(6/11);非实性成分为主的部分实性结节中,高分化腺癌占31.25%(5/16),而在实性成分为主的部分实性结节中,高分化腺癌占14.29%(2/14);在实性结节中,高分化腺癌占10.00%(2/20)。毛刺征和胸膜牵拉征在低分化腺癌病灶中较中或高分化腺癌多见。结论 同一患者同时多原发肺腺癌不同癌灶的影像学表现有所差别。结节密度与组织分化之间存在一定关系,实性成分越多,提示分化程度越低。 |
| 英文摘要: |
| Objective To explore CT features of synchronous multiple primary lung adenocarcinomas. Methods CT and histopathological findings of 29 patients with synchronous multiple primary lung adenocarcinomas were analyzed and compared retrospectively. Results The ratio of unilateral synchronous multiple primary lung adenocarcinomas (27/29, 93.10%) was higher than bilateral ones (2/29, 6.90%). The ratio of synchronous multiple primary lung adenocarcinomas in different lobes was higher (20/27, 74.07%) than that in the same lobe (7/27, 25.93%), of two nodules (28/29, 96.55%) was higher than of multiple nodules (1/29, 3.45%). Moderate-differentiation was the first common subtype in synchronous multiple primary lung adenocarcinoma (30/61, 49.18%). No similar imaging characteristics of synchronous multiple primary lung adenocarcinomas were found in the same patient. Well-differentiation (13/30, 43.33%) was the first common subtype in lesions ≤1.5 cm, moderate-differentiation (18/24, 75.00%) was the most in lesions sized 1.6—3.0 cm, and poor-differentiation (3/7, 42.86%) was the first common in lesions >3.0 cm. In non-solid nodules on CT, well-differentiation lesions accounted for 54.55% (6/11). In part-solid nodules with more non-solid components on CT, well-differentiation lesions accounted for 31.25% (5/16). In part-solid nodules with more solid components on CT, well-differentiation lesions accounted for 14.29% (2/14). In solid nodules on CT, well-differentiation accounted lesions for 10.00% (2/20). The spicule sign and pleural indentation of nodules were more in poor-differentiation than that in others. Conclusion There are discrepant features in synchronous multiple primary lung adenocarcinomas for each patient. Certain relation exists between the density of nodules and histopathological differentiations. The more the solid components of nodules, the lower the differentiation. |
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