肺腺癌患者CT影像预测纯磨玻璃结节浸润程度及对肺结节病理性质的判定价值

  目的  研究肺腺癌患者CT影像对纯磨玻璃结节(PGGN)浸润程度及对肺结节病理性质的预测价值。  方法  采用回顾性研究方法，以我院2017年1月~2021年1月住院治疗的122例PGGN患者作为研究对象。根据肺腺癌的种类分组，其中侵袭前组患者82例原位腺癌(AIS)组患者39例，微浸润性腺癌(MIA)组患者43例，侵袭组患者40例; 根据肺腺癌良恶性分组，其中良性组80例，恶性组42例。比较侵袭前组与侵袭组、AIS组与MIA组以及良性组与恶性组患者的病灶直径、CT值、形状、瘤肺界面、毛刺征、空泡征、三维形状、分叶征、空气支气管征、胸膜凹陷症情况之间的差异。  结果  侵袭前组以及侵袭组患者的病灶直径、CT值、形状、毛刺征、分叶征、空气支气管征情况之间的差异有统计学意义(P < 0.05);AIS以及MIA组患者的分叶征、空泡征、CT值之间的差异有统计学意义(P < 0.05);良性组以及恶性组患者的瘤肺界面、病灶直径、CT值、形状、毛刺征、分叶征、空气支气管征情况之间的差异有统计学意义(P < 0.05);病灶直径、CT值、形状、毛刺征、分叶征、空气支气管征联合检测对肺癌的侵袭以及恶性组患者的诊断敏感度高于单独检测; ROC曲线分析示，病灶直径、CT值、形状、毛刺征、分叶征、空气支气管征联合检测对浸润性以及恶性肿瘤的曲线下面积高于单独检测。  结论  肺腺癌患者CT影像对于PGGN浸润程度及对肺结节病理性质具有显著的预测价值。 

CT image prediction of pure ground-glass nodule invasion degree and pathological nature of pulmonary nodules in patients with lung adenocarcinoma

  Objective  To explore the predictive value of CT images in the degree of pure ground-glass nodule (PGGN) infiltration and the pathological properties of pulmonary nodules in patients with lung adenocarcinoma.  Methods  A total of 122 patients with pggn hospitalized in our hospital from January 2017 to January 2021 were selected. According to the types of lung adenocarcinoma, 82 patients in the pre invasion group 39 patients in adenocarcinoma in situ (AIS) group and 43 patients in microinvasive adenocarcinoma (MIA) group] and 40 patients in the invasion group. According to the classification of benign and malignant lung adenocarcinoma, there were 80 cases in benign group and 42 cases in malignant group. We compared the differences of lesion diameter, CT value, shape, tumor lung interface, hairpin sign, vacuole sign, three-dimensional shape, lobulation sign, air bronchus sign and pleural indentation between the pre invasion group and the invasion group, AIS group and MIA group, benign group and malignant group.  Results  The differences of lesion diameter, CT value, shape, burr sign, lobulation sign and air bronchogram sign between the pre invasion group and the invasion group were significant (P < 0.05). The differences of lobation sign, vacuole sign and CT value between AIS and MIA groups were statistically significant (P < 0.05). The differences of tumor lung interface, lesion diameter, CT value, shape, burr sign, lobulation sign and air bronchial sign between benign group and malignant group were significant (P < 0.05). The diagnostic sensitivity of combined detection of lesion diameter, CT value, shape, burr sign, lobulation sign and air bronchogram sign in patients with lung cancer invasion and malignant group was significantly higher than that of single detection. ROC curve analysis showed that the area under the curve of the combined detection of lesion diameter, CT value, shape, burr sign, lobulation sign and air bronchial sign were significantly higher than that of the single detection.  Conclusion  CT images of patients with lung adenocarcinoma have significant predictive value for the degree of PGGN infiltration and the pathological properties of pulmonary nodules.