目的探讨含不同实性成分比例磨玻璃密度病灶(GGO)肺腺癌的侵袭性差异。方法回顾性分析59例含GGO、经手术病理证实为肺腺癌患者的CT及病理资料。分析病灶薄层CT影像征象,根据肿瘤内实性成分最大径与肿瘤最大径比值将患者分为GGO为主组即GG组和实性成分为主组即Gc组,比较两组肿瘤CT征象和侵袭性差异。结果病灶平均直径(2.71±1.08)cm;纯GGO8例,混杂GGO51例;43例病灶内见空泡征及含气支气管征(43/51,72.9%),53例病灶边界清晰(53/59,89.83%)。Gc组19例、Gc组40例。CT征象:两组病灶直径、部位、形状及边界是否清晰差异均无统计学意义(P均〉0.05);Gc组边缘分叶和(或)毛刺比例、空泡征及胸膜凹陷征比例均明显高于Gc组(P均〈0.05)。病理结果:Gc组与GG组淋巴结转移、脉管癌栓发生率差异均无统计学意义(P均〉O.05);Gc组胸膜侵犯率和病理分期高于GG组(P均〈O.05)。结论表现为GGO的肺腺癌随肿瘤实性成分比例增高,出现恶性CT征象比例和肿瘤侵袭性升高。
Objective To compare the difference of pathological invasiveness between lung adnenocarcinomas presenting as ground-glass opacity (GGO) with different proportion of consolidation. Methods CT and pathological data of 59 patients with adenocarcinoma confirmed by pathology presenting as GGO on CT were retrospectively studied. The thin-slice images of the focal lesions were analyzed and according to the maximal diameter ratio of the consolidation and the tumor, the patients were divided into main GGO group (GG) and main consolidation group (Gc). The CT features and pathological invasiveness of the tumor were observed and compared. Results The diameter of the lesions was (2.71±1.08)cm. There were 8 of pure GGOs and 51 of mixed GGOs. Bubble-like low attenuation appeared in 43 (43/59, 72.88%) cases and most of the lesions (53/59, 89.83%) had clear margin. There were 19 cases in GG group and 40 cases in Gc group. CT features.. There was not obvious difference of the tumor diameter, location, shape and clear margin between the two groups (all P〉0.05). The ratios of lobulated and (or) burr margin, sign of bubble-like attenuation and pleural indentation in Gc group were higher than those in Gc group (all P〈0.05). Pathology results: No differences of lymph node metastasis and cancer embolus were found (both P〉0.05) between the two groups. The rate of pleural invasion and the pathological staging were higher in Gc group than those in Gc group (both P〈0.05). Conclusion With increasing of the solid component ratio in lung adenocarcinas presenting as GGO, the lesions are tended to demonstrate malignant features in CT and high invasiveness in pathology.