| 摘要: |
| 目的探讨平均CT值测量对≤1cm同时多原发肺腺癌亚型分型的诊断价值。方法收集CT检查并手术病理证实的≤1cm同时多原发肺腺癌78例共162枚结节，根据手术病理分为浸润前病变组23例70枚结节，浸润性病变组50例87枚结节[其中微浸润腺癌（MIA）22例46枚，浸润性腺癌（IAC）28例41枚]。利用医学影像存储和传输系统工作站，在横断薄层肺窗图像上对磨玻璃影直径最大层面进行平均CT值测量，利用ROC曲线确定最佳临界CT值。结果浸润前病变组的CT值-817～-420（-629.41±69.85）Hu，明显低于浸润性病变组-698～-31（-412.9±144.3）Hu（t=-11.510，P＜0.01）；浸润性病变组中MIA者的CT值-698～-178（-460.61±73.09）Hu，明显低于IAC者的CT值-538～-31（-294.55±176.65）Hu（t=-7.370，P＜0.01）。当平均CT值＞-530Hu时，其鉴别浸润前病变和浸润性病变效能最佳，AUC为0.901，诊断灵敏度、特异度分别为0.871、0.776；当平均CT值＞-422Hu时，其鉴别MIA和IAC的效能最佳，AUC为0.901，诊断灵敏度、特异度分别为0.703、0.881。结论平均CT值测量在≤1cm同时多原发肺腺癌亚型分型诊断中有较高的应用价值，可以对同时多原发肺腺癌的亚型做出判断，为临床进一步诊疗提供重要参考依据。 |
| 关键词: 肺肿瘤 同时多原发肿瘤 体层摄影术 X 线计算机 |
| DOI：10.12056/j.issn.1006-2785.2017.40.4.2017-1283 |
| 分类号: |
| 基金项目:舟山市科技计划项目（2015c31032） |
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| Mean CT value in diagnosis of small synchronous multiple primary lung cancer subtypes |
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Zhoushan Hospital
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| Abstract: |
| Objective To evaluate the application of the mean CT value in diagnosis of small synchronous multiple primary lung adenocarcinoma subtypes. Methods Seventy-eight patients underwent CT scan, 162 nodules of diameter ≤1cm were detected and pathologically diagnosed as synchronous primary lung adenocarcinoma. According to pathology, 70 nodules in 23 cases were preinvasive lesions and 87 nodules in 50 cases were invasive lesions, including 46 nodules in 22 cases were
micro invasive adenocarcinoma (MIA) and 41 nodules in 28 cases were invasive adenocarcinomas (IAC). The mean CT value was measured and its optimal cut-off point for differential diagnosis of subtypes was analyzed with receive operating characteristic (ROC) curve. Results The mean CT value of preinvasive group was -629.41±69.85 (-817～-420) Hu, which was significantly
lower than that of invasive group [-412.9±144.3 (-698～-31)Hu, t=-11.510, P＜0.01]; The mean CT value was -460.61±73.09
(-698～-178)Hu in MIA group, which was significantly lower than that of IAC group [-294.55±176.65(-538～-31) Hu, t=-7.370, P＜0.01). The area under curve (AUC) of CT value in differentiating preinvasive lesions and invasive lesions was 0.901; taking
-530Hu as cutoff value the diagnostic sensitivity and specificity were 0.871 and 0.776, respectively. The area under ROC curve of mean CT value for differentiating between MIA and IAC was 0.901, taking -422Hu as cutoff value, the diagnostic sensitivity and specificity were 0.703 and 0.881, respectively. Conclusion The mean CT value is of value in diagnosis of subtypes of small synchronous primary lung adenocarcinoma. |
| Key words: Lung neoplasms Simultaneous multiple primary tumors Tomography X-ray computed |
