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。≤1.5cm病灶中,以高分化腺癌占首位(13/30,43.33%);1.6～3.0cm病灶以中分化腺癌多见(18/24,75.00%);>3.0cm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。
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 41.5 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, welldifferentiation 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.
出处
《中国医学影像技术》
CSCD
北大核心
2012年第4期676-679,共4页
Chinese Journal of Medical Imaging Technology
关键词
肺肿瘤
肿瘤
多原发
体层摄影术
X线计算机
病理学
Lung neoplasms
Neoplasms, multiple primary
Tomography, X-ray computed
Pathology
作者简介
周丽娜（1982-），女，甘肃天水人，在读博士。研究方向：胸部影像诊断。Email：ts20001020@163．com
[通讯作者]吴宁，中国医学科学院北京协和医学院肿瘤医院影像诊断科，100021。E—mail：cir．wuning@vip．163．com
