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CT 灌注成像参数评估孤立性肺结节的诊断价值--Meta 分析

ISSN号：1002-1671
期刊名称：《实用放射学杂志》
时间：0
分类：R734.2[医药卫生—肿瘤;医药卫生—临床医学] R814.42[医药卫生—影像医学与核医学;医药卫生—放射医学;医药卫生—临床医学]
作者机构：[1]第二军医大学附属长征医院医学影像科,上海200003, [2]同济大学附属上海市肺科医院影像科,上海200433, [3]同济大学附属上海市东方医院影像科,上海200085
相关基金：基金项目：国家自然科学基金面上项目（81271572）;上海市市级医院适宜技术项目（SHDC12014227）;保健专项科研课题（14BJZ50）;国家自然科学青年基金项目（81301252）.

关键词：小细胞肺癌, 肺腺癌, 肺鳞癌, 计算机体层成像, small cell lung cancer, lung adenocarcinoma, lung squamous cell carcinoma, computed tomography

中文摘要：

目的探讨串珠征的形成机制，评价其在周围型小细胞肺癌（SCLC）、周围型肺腺癌及周围型肺鳞癌中的鉴别诊断意义。方法收集病理证实的周围型SCLC78例、周围型肺腺癌69例、周围型肺鳞癌33例，分别统计串珠征的阳性率、纵隔淋巴结的转移率及纵隔淋巴结大于肺原发灶的比例，对相关数据进行统计分析。结果78例周围型SCLC中10例串珠征阳性（12．8％），且纵隔淋巴结均大于肺原发灶；78例中63例纵隔淋巴结转移（80．8％），42例纵隔淋巴结大于肺原发灶（53.8％）。69例周围型实性肺腺癌中，无1例出现串珠征，25例纵隔淋巴结转移（36．2％），2例纵隔淋巴结大于原发灶（2．9％）。33例周围型肺鳞癌中1例串珠征阳性（2．8％），该例肺门淋巴结明显小于肺原发灶，33例中13例纵隔淋巴结转移（39．4％），6例纵隔淋巴结大于原发灶（16．7％）。经统计分析，串珠征在周围型SCLC与周围型肺鳞癌中差异无统计学意义，周围型SCLC与周围型肺腺癌、肺鳞癌在纵隔淋巴结转移率及纵隔淋巴结大于肺原发灶的阳性率差异均有统计学意义。结论串珠征在一定程度上反映SCLC的生物学特性，在周围型SCLC与周围型肺腺癌、肺鳞癌的鉴别诊断中有重要价值，应结合纵隔淋巴结大小。

英文摘要：

Objective To investigate the formation mechanism of string beads sign in peripheral small cell lung cancer （SCLC） and evaluate the significance of it in differential diagnosis among SCLC, peripheral lung adenocarcinoma and peripheral lung squa- mous cell carcinoma.Methods 78 cases of SCLC, 69 cases of peripheral lung adenocarcinoma and 33 cases of peripheral lung squa- mous cell carcinoma, confirmed pathologically were included in this study. The positive rates of string beads sign, mediastinal lymph node metastasis and mediastinal lymph nodes larger than primary lung lesions were calculated and analyzed in these three groups.Results 10 out of SCLC cases （12.8%） have string beads sign, in which all mediastinal lymph nodes were larger than lung lesions. Mediasti- hal lymph node metastases were observed in 63（80.8%） of 78 cases, and 42 （53.8%）cases had larger mediastinal lymph nodes than lung lesions. No string beads sign was observed in patients with peripheral solid lung adenocarcinomas, but 25 of 69 cases （36.2%） have medias tinal lymph node metastasis and 2 cases { 2.9 % ） had larger mediastinal lymph nodes than lung lesions. 13 cases（ 39.4 %） of 33 patients with peripheral lung squamous cell carcinomas had mediastinal lymph node metastasis, and 6 eases （16.7 %） had larger mediastinal lymph nodes than lung lesions. The statistical results showed the positive rate of string beads sign was not significantly different between peripheral SCLC group and peripheral lung squamous cell carcinoma group, but that of rnediastinal lymph node and larger mediastinal lymph nodes than lung lesions were statistically different among these three groups.Conclusion To some extent.string beads sign on CT could reflect the biologic character of SCLC. It played an important role in differential diagnosis of peripheral SCLC, peripheral lung adenocarcinoma and periph- eral lung squamous cell carcinoma, but it should be combined with mediastinal lymph node size.

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