肺部多个结节连续性病例40例临床分析

发布时间：2017-12-27 05:36

本文关键词：肺部多个结节连续性病例40例临床分析　出处：《实用医学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的:研究肺部多个结节疾病构成、诊断技术及影像学特征。方法:前瞻性研究2012年6月至2013年5月确诊的40例肺部多个结节连续性病例的临床资料、影像学特征和诊断方法。根据确诊结果分为良性和恶性病变组,并比较上述观察指标。结果:40例肺部多个结节病例中良性组17例(42.5%),恶性组23例(57.5%)。与良性组比较,恶性组平均年龄及血CEA阳性率明显较高[(65.5±10.0)岁vs.(50.3±11.8)岁,(39.1%vs.5.9%)];恶性组(91.3%)因各种呼吸道症状就诊高于良性组(58.8%)。最大结节CT特征中,恶性组分叶征20例(87.0%)、纵隔淋巴结肿大10例(43.5%),分别高于良性组的9例(52.9%)和1例(5.9%);良性组中最大结节尖角征(10例,58.8%)明显高于恶性组(4例,17.4%)。CT引导经皮穿刺肺活检术和纤维支气管镜检查确诊例数/检查例数分别为94.7%、46.4%。结论:肺部多个结节的良、恶性发病率相近,血CEA和CT特征为鉴别肺部多个结节的性质提供一定参考价值,而CT引导经皮穿刺肺活检术是肺部多个结节病理组织学诊断的有效方法。
[Abstract]:Objective: To study the constitution, diagnostic techniques and imaging features of multiple pulmonary nodules. Methods: the clinical data, imaging features and diagnostic methods of 40 consecutive cases of multiple pulmonary nodules diagnosed from June 2012 to May 2013 were prospectively studied. The results were divided into benign and malignant groups according to the results of the diagnosis, and the above observation indexes were compared. Results: among the 40 cases of multiple pulmonary nodules, 17 cases (42.5%) were in benign group and 23 cases in malignant group (57.5%). Compared with the benign group, the average age and blood CEA positive rate in the malignant group were significantly higher than those in the benign group [(65.5 + 10) years old, vs. (50.3 + 11.8) years old, (39.1%vs.5.9%)]; the malignant group (91.3%) was higher than the benign group (58.8%) because of various respiratory symptoms. In the CT features of the largest nodules, 20 cases (87%) of malignant components, 10 cases (43.5%) of mediastinal lymph nodes, and 9 cases (52.9%) and 1 cases (5.9%) of mediastinal lymph nodes were higher than those of benign group, respectively. In the benign group, the maximum tubercle corner sign (10 cases, 58.8%) was significantly higher than that of malignant group (4 cases, 4). The number of cases confirmed by CT guided percutaneous lung biopsy and fiberoptic bronchoscopy was 94.7% and 46.4%, respectively. Conclusion: the incidence of benign and malignant multiple nodules is similar. The characteristics of blood CEA and CT can provide some reference value for identifying the nature of multiple pulmonary nodules. CT guided percutaneous lung biopsy is an effective method for histopathological diagnosis of multiple nodules in the lung.
【作者单位】：广西壮族自治区人民医院;
【基金】：广西卫生厅自筹经费课题(编号:Z2013332)
【分类号】：R563
【正文快照】： 随着高分辨螺旋CT的应用,越来越多的肺内结节病灶被发现。肺部单个结节性疾病的诊疗方法已经被广泛接受,肺部多个结节也并不罕见。第七版肺癌分期中,原发肿瘤之外的肺结节定为转移灶,但是在临床工作中肺部多个结节疾病种类较多,这些肿瘤结节同样为原发肺癌的情况也时有发生,临

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