切换至 "中华医学电子期刊资源库"

中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (01) : 58 -60. doi: 10.3877/cma.j.issn.1674-6902.2023.01.013

临床研究

CT影像学征象对局灶性肺炎型肺癌与肺部炎性病变的鉴别意义
徐冰1,(), 程明斌1, 赵国华1   
  1. 1. 101300 北京,北京市顺义区医院放射科
  • 收稿日期:2022-10-23 出版日期:2023-02-25
  • 通信作者: 徐冰

Significance of CT imaging findings in differentiating focal pneumonic lung cancer from pulmonary inflammatory lesions

Bing Xu1(), Mingbin Cheng1, Guohua Zhao1   

  • Received:2022-10-23 Published:2023-02-25
  • Corresponding author: Bing Xu
引用本文:

徐冰, 程明斌, 赵国华. CT影像学征象对局灶性肺炎型肺癌与肺部炎性病变的鉴别意义[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(01): 58-60.

Bing Xu, Mingbin Cheng, Guohua Zhao. Significance of CT imaging findings in differentiating focal pneumonic lung cancer from pulmonary inflammatory lesions[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(01): 58-60.

目的

分析CT影像学征象联合模型对局灶性肺炎型肺癌(focal pneumonic lung cancer, FPLC)和局灶性肺部炎性病变(focal pulmonary inflammatory Lesions, FPIL)鉴别诊断意义。

方法

选择2021年6月至2022年6月我院收治的FPLC患者39例为观察组,FPIL患者25例为对照组。比较两组临床特征和CT征象,构建临床联合CT影像特征模型,采用受试者特征曲线(ROC)分析模型对FPLC和FPIL的鉴别诊断。

结果

观察组较对照组年龄,有吸烟史(51.28% vs. 44.00%)和无呼吸系统症状(33.33% vs. 20.00%)显著(P<0.05);观察组较对照组病灶小(40.28±16.39 mm vs. 45.39±17.72 mm),多见空气支气管征(30.77% vs. 16.00%)(P<0.05);对照组较观察组多见坏死(48.00% vs. 10.26%)和胸膜粘连(72.00% vs. 41.05%)(P<0.01)。综合模型显示年龄[OR(95%CI): 4.37(2.19~9.14)]、呼吸系统症状[OR(95%CI): 1.87 (1.12~2.44)]、空气支气管征[OR(95%CI): 2.93 (1.82~4.44)]、坏死[OR(95%CI): 5.79(2.69~14.83)]和胸膜粘连[OR(95%CI): 8.42 (3.31~17.94)]是区分FPIL和FPLC的预测因素(P<0.05)。模型AUC 0.856(95%CI:0.765~0.946),灵敏度81.5%,特异度85.3%。

结论

综合模型结合临床特征和CT影像特征,鉴别局灶性肺炎样肺癌和局灶性肺部炎症病变,具有临床意义。

表1 两组患者临床特征对比[n(%)]
表2 两组患者CT征象比较[n(%)]
1
王洪武,金发光. 晚期非小细胞肺癌多域整合治疗策略[J/CD]. 中华肺部疾病杂志(电子版), 2022, 15(4): 457-461.
2
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020[J]. CA Cancer J Clin, 2020, 70(1): 7-30.
3
Stinchcombe TE, Socinski MA. Current treatments for advanced stage non-small cell lung cancer[J]. Proc Am Thorac Soc, 2009, 6(2): 233-241.
4
Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424.
5
Feng RM, Zong YN, Cao SM, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?[J]. Cancer Commun (Lond), 2019, 39(1): 22.
6
王 军,于刚刚,都凌杰,等. 肺炎型肺癌五例误诊分析[J]. 中国综合临床2021, 37(4): 308-311.
7
Wu J, Wang Z, Pan J, et al. Value of CT diagnosis in pneumonia type mucinous adenocarcinoma[J]. J Clin Pathol Res, 2017, 37(10): 2137-2143.
8
Takehana K, Sakamoto R, Fujimoto K, et al. Peritumoral radiomics features on preoperative thin-slice CT images can predict the spread through air spaces of lung adenocarcinoma[J]. Sci Rep, 2022, 12(1): 10323.
9
Gong JW, Zhang Z, Luo TY, et al. Combined model of radiomics, clinical, and imaging features for differentiating focal pneumonia-like lung cancer from pulmonary inflammatory lesions: an exploratory study[J]. BMC Med Imaging, 2022, 22(1): 98.
10
Han J, Wu C, Wu Y, et al. Comparative study of imaging and pathological evaluation of pneumonic mucinous adenocarcinoma[J]. Oncol Lett, 2021, 21(2): 125.
11
Borczuk AC. Prognostic considerations of the new World Health Organization classification of lung adenocarcinoma[J]. Eur Respir Rev, 2016, 25(142): 364-371.
12
吴春燕,何川东,陈正国,等. 肺炎性假瘤、周围型肺癌的CT影像学特征及其鉴别诊断[J]. 中国CT和MRI杂志2022, 20(4): 51-52,68.
13
袁方方,翟 明,丁亚冬. 肺炎型肺癌与大叶性肺炎的CT影像鉴别诊断[J]. 医学影像学杂志2022, 32(11): 2004-2006.
14
Snoeckx A, Dendooven A, Carp L, et al. Wolf in sheep′s clothing: Primary lung cancer mimicking benign entities[J]. Lung Cancer, 2017, 112: 109-117.
15
Kim TH, Kim SJ, Ryu YH, et al. Differential CT features of infectious pneumonia versus bronchioloalveolar carcinoma (BAC) mimicking pneumonia[J]. Eur Radiol, 2006, 16(8): 1763-1768.
16
杨晓静. 高分辨胸部CT对肺炎型肺癌的鉴别诊断价值研究[J]. 中国CT和MRI杂志2022, 20(5): 77-79, 91.
17
Cufer T, Ovcaricek T, O′Brien ME. Systemic therapy of advanced non-small cell lung cancer: major-developments of the last 5-years[J]. Eur J Cancer, 2013, 49(6): 1216-1225.
18
Khan MF, Straub R, Moghaddam SR, et al. Variables affecting the risk of pneumothorax and intrapulmonal hemorrhage in CT-guided transthoracic biopsy[J]. Eur Radiol, 2008, 18(7): 1356-1363.
19
Wu CC, Maher MM, Shepard JA. Complications of CT-guided percutaneous needle biopsy of the chest: prevention and management[J]. AJR Am J Roentgenol, 2011, 196(6): W678-682.
20
Wang T, Yang Y, Liu X, et al. Primary invasive mucinous adenocarcinoma of the lung: Prognostic value of CT imaging features combined with clinical factors[J]. Korean J Radiol, 2021, 22(4): 652-662.
21
Huo JW, Huang XT, Li X, et al. Pneumonic-type lung adenocarcinoma with different ranges exhibiting different clinical, imaging, and pathological characteristics[J]. Insights Imaging, 2021, 12(1): 169.
22
Chu ZG, Sheng B, Liu MQ, et al. Differential diagnosis of solitary pulmonary inflammatory lesions and peripheral lung cancers with contrast-enhanced computed tomography[J]. Clinics (Sao Paulo), 2016, 71(10): 555-561.
23
Gaikwad A, Souza CA, Inacio JR, et al. Aerogenous metastases: a potential game changer in the diagnosis and management of primary lung adenocarcinoma[J]. AJR Am J Roentgenol, 2014, 203(6): W570-582.
24
Nie K, Nie W, Zhang YX, et al. Comparing clinicopathological features and prognosis of primary pulmonary invasive mucinous adenocarcinoma based on computed tomography findings[J]. Cancer Imaging, 2019, 19(1): 47.
25
Cha YJ, Kim HR, Lee HJ, et al. Clinical course of stage Ⅳ invasive mucinous adenocarcinoma of the lung[J]. Lung Cancer, 2016, 102: 82-88.
26
Li J, Yen A, Lin GY. Recurrent pneumonia, persistent cough, and dyspnea in a 41-year-old man[J]. Chest, 2012, 142(5): 1338-1342.
27
Zhang T, Yuan M, Zhong Y, et al. Differentiation of focal organising pneumonia and peripheral adenocarcinoma in solid lung lesions using thin-section CT-based radiomics[J]. Clin Radiol, 2019, 74(1): 78 e23-78 e30.
28
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation[J]. Cell, 2011, 144(5): 646-674.
29
Li Y, Yang ZG, Chen TW, et al. First-pass perfusion imaging of solitary pulmonary nodules with 64-detector row CT: comparison of perfusion parameters of malignant and benign lesions[J]. Br J Radiol, 2010, 83(993): 785-790.
30
Wang M, Li B, Sun H, et al. Correlation study between dual source CT perfusion imaging and the microvascular composition of solitary pulmonary nodules[J]. Lung Cancer, 2019, 130: 115-120.
[1] 张焱, 刘春媚, 姚瑾, 陈苗苗, 徐雯, 黄品同. 超声O-RADS分类和临床特征对不同病理类型卵巢浆液性肿瘤的诊断价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(03): 268-274.
[2] 罗敏华, 王文平, 孔文韬. 肝脏炎性假瘤的超声造影表现及其诊断价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(03): 297-303.
[3] 顾盼盼, 董传莉, 宋梦瑶, 瞿色华, 杨小迪, 周瑞. 不完全性川崎病患儿临床特征及冠状动脉损害情况分析[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(04): 446-451.
[4] 丁科, 张亚琼, 刘杰, 邓莉平, 张永喜, 熊勇. 获得性免疫缺陷综合征相关淋巴瘤患者的临床特征及生存状况的变化趋势[J/OL]. 中华实验和临床感染病杂志(电子版), 2024, 18(05): 278-284.
[5] 张超, 张珍, 马梁, 穆欢欢, 刘彩玲. 腹腔镜胰十二指肠切除术术后C级胰瘘患者临床特征及影响因素研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 675-678.
[6] 高佳, 姜吉询, 王鑫, 吴婷, 向江明. 病理性乳头溢液单中心临床分析附168例报告[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 323-326.
[7] 颜晓敏, 崔嵘嵘. 23例乳腺佩吉特病的经验交流[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(03): 353-354.
[8] 杨柳, 陈佳, 孙雅娟, 陈娇, 谭明超, 龚明福. 抗中性粒细胞胞浆抗体相关性血管炎的胸部CT 及临床特征分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 744-749.
[9] 杨攀, 黄晓寒, 邓才霞, 周利航, 周向东, 罗虎. SMARCA4缺失的胸部未分化肿瘤临床特征及预后分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 529-534.
[10] 廖一凡, 张松, 万宝玉, 黄文杰, 李嘉旭, 邓婕, 胡洁, 秦显莉. 18F-FDG PET/CT在肺孤立实性结节良恶性鉴别诊断中的价值分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 373-378.
[11] 何俊, 易淑华, 陈婷婷, 杨玉, 李红雨, 谢飞, 何健. 妊娠并发社区获得性肺炎临床特征及降钙素原和炎症指数对其诊断意义[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 421-425.
[12] 刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[13] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[14] 刘昌恩, 李岩, 张其德. 基于内镜筛查发现的自身免疫性胃炎的临床特征分析[J/OL]. 中华胃肠内镜电子杂志, 2024, 11(04): 233-237.
[15] 王宇, 张泽锴, 吴明胜, 王高祥, 孙效辉, 王君, 徐美青, 李田, 徐世斌, 解明然. 术后病理诊断为良性肺结节323例患者临床特征分析[J/OL]. 中华胸部外科电子杂志, 2024, 11(03): 167-174.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?