摘要
目的探讨肺部孤立磨玻璃结节（GGO）的临床特征和cT征象在良恶性鉴别中的价值。方法回顾本院2011年1月至2013年3月经组织病理学确诊的108例孤立GGO病例，分析临床表现、影像特征与病理诊断的相关性，并统计GGO随访结果。结果108例患者中男52例，女56例，年龄26～80（58．12±10．34）岁。其中良性19例，恶性89例。良恶性GGO者年龄、性别、临床症状、边缘（毛刺、棘状突起）、内部结构（空泡征、支气管充气征）、血管集束征间的差异无统计学意义（P〉0．05）；而在淋巴细胞百分比、形态（圆形／不规则形）、边缘（分叶）、界面（清楚／模糊）、胸膜凹陷征间的差异有统计学意义（P〈0．05）；胸膜凹陷征在细支气管肺泡癌（BAC）和腺癌两组间的差异有统计学意义（P=0．0252）。44例患者初次发现GGO后进行随访，其中7例（7／44，15．91％）GGO随访3年后较前增大或变实；32例GGO患者随访无明显变化，且恶性组年龄较良性组大（P=0．0416）。结论临床症状难以鉴别GGO的良恶性，影像上表现为圆形／类圆形、分叶、界面清楚、胸膜牵拉征多提示恶性。在CT随访过程中，GGO病灶增大、实性成分增多是手术切除的指征。性质不明GGO随访时间至少3年。
Objective To investigate the clinical and computed tomography （CT） features of lung isolated ground-glass opaci- ty and to analyze the predictive factors that may discriminate benign from malignant nodules. Methods Clinical features, CT charac- teristics, pathological diagnosis, and the follow-up results were retrospectively analyzed with 108 cases of isolated ground-grass opacity （GGO） that was confirmed by histopathology from January 2011 to March 2013. Results A total of 108 isolated GGOs [52 men,56 women,mean age （58. 12 ＋ 10. 34）years] included 19 benign nodules and 89 malignant nodules. The diversity of age, gender, clini- cal symptom, margin （speculation, spineqike process）, internal characteristics （ovule sign, air bronchograms） of the lesions were no statistically significant differences between benign and malignant GGOs （ P 〉 0. 05）. The lymphocyte and CT findings of shape, lobu- lation, interface （ill/well defined） and pleural indentation sign were significantly different between benign and malignant GGOs （ P 〈 0. 05）. Besides significant difference in pleural indentation sign was also found between bronchioalveolar carcinoma and adenocarcino- ma （ P =0. 0252）. Among the 44 patients who were followed up after finding GGO initially, there were 7 GGOs （7/44,15.91%） to grow up after 3years, and GGOs of 32 patients had no obvious change, besides the patients＇age of malignant GGO was bigger than the benign（ P =0. 0416）. Conclusions Clinical features were of little value to discriminate the benign from malignant GGOs. CT fea- tures including round/oval shape, lobulation, and well defined and pleural indentation sign were of important value in the diagnosis of malignant GGO. Surgical resection should be applied in the process of follow-up when the sizes of GGO become bigger or newly formed solid components were detected. GGO that cant be diagnosed should be followed up for at least 3 years.
出处
《中国医师杂志》
CAS
2014年第2期214-217,共4页
Journal of Chinese Physician
作者简介
通信作者：余秉翔，Email：bingxiang_yu@hotmail．com
