不同类型肺结节的生长曲线分析
发布时间：2018-12-13 18:42
【摘要】：背景与目的计算机断层扫描(computed tomography,CT)随访评估肺内结节的生长特性是临床判断结节良恶性的常用策略。不同生物学行为的肺结节可能具有不同的生长速度和生长模式。本研究的目的是绘制不同类型肺结节的体积生长曲线,了解其生长方式,为判断结节性质并制定肺结节随访方案提供依据。方法应用三维分析软件对111例接受2次及以上CT检查的肺结节(实性结节54例、亚实性结节57例)的影像资料进行回顾性分析。35例恶性及5例良性结节经病理或组织学确认,其余71例经两年随访无显著生长,经专家会诊确认为肺癌低危结节。所有结节按密度及性质分组:实性良性/低危结节、实性恶性结节、亚实性良性/低危结节、亚实性恶性结节。以随访间隔时间(d)为X轴,以随访结节的三维体积(mm3)和三维体积对数为Y轴,绘制体积线性及指数性生长曲线,由研究者主观观察曲线的形态。应用卡方检验比较不同性质肺结节的生长曲线的差异。结果实性恶性结节中12例(66.7%)生长曲线快速上升,3例(16.7%)先平缓-后上升,2例(11.1%)缓慢上升,1例(5.56%)平直。亚实性恶性结节中8例(47.1%)呈快速上升型,4例(23.5%)缓慢上升,3例(17.6%)平直,2例(11.8%)为先下降-后上升型。实性良性/低危结节中5例(13.9%)呈下降型,17例(47.2%)平直,8例(21.6%)缓慢上升,6例(16.7%)呈波浪型。亚实性良性/低危结节中4例(10%)呈下降型,21例(52.5%)平直,9例(22.5%)缓慢上升,6例(15%)呈波浪型。良性/低危结节与恶性结节生长曲线分布存在显著性差异(χ2=42.4,P0.01)。结论肺癌生长曲线具有异质性,快速上升是恶性肺结节的特征性生长曲线,但部分可在一定时期内表现为平直、缓慢上升甚至下降。缓慢生长不能排除肺癌可能,尤其是亚实性结节。
[Abstract]:Background & objective to evaluate the growth characteristics of pulmonary nodules by computed tomography (computed tomography,CT) follow-up is a common strategy in clinical diagnosis of benign and malignant nodules. Pulmonary nodules with different biological behaviors may have different growth rates and patterns. The purpose of this study was to draw the volume growth curves of different types of pulmonary nodules, to understand their growth patterns, and to provide evidence for judging the nature of nodules and making follow-up plans for lung nodules. Methods the imaging data of 111 cases of pulmonary nodules (54 solid nodules and 57 subsolid nodules) which underwent CT examination twice or more were analyzed retrospectively. 35 cases of malignant nodules and 5 cases of benign nodules were confirmed by pathology or histology. The other 71 cases were diagnosed as low risk nodules of lung cancer after two-year follow-up. All nodules were classified according to density and nature: solid benign / low risk nodules, solid malignant nodules, subsolid benign / low risk nodules, subsolid malignant nodules. The linear and exponential growth curves were drawn using (d) as X axis and mm3 and logarithm of 3D volume as Y axis. The shape of the curve was observed subjectively. Chi-square test was used to compare the difference of growth curves among different types of pulmonary nodules. In 12 cases (66.7%), the growth curve of fruit bearing malignant nodules increased rapidly, 3 cases (16.7%) were flat first and then increased, 2 cases (11.1%) slowly increased, and 1 case (5.56%) was straight. Among the subsolid malignant nodules, 8 cases (47.1%) showed a rapid upward pattern, 4 cases (23.5%) slowly increased, 3 cases (17.6%) were flat, and 2 cases (11.8%) showed the first descending and then ascending type. In 5 cases (13.9%) of solid benign / low risk nodules, 17 cases (47.2%) were flat, 8 cases (21.6%) were slowly ascending, and 6 cases (16.7%) were wavy. Of the subsolid benign / low risk nodules, 4 cases (10%) showed descending type, 21 cases (52.5%) were flat, 9 cases (22.5%) increased slowly, and 6 cases (15%) were wavy. There was significant difference in the distribution of growth curve between benign and low risk nodules and malignant nodules (蠂 2 / 42.4 P 0.01). Conclusion the growth curve of lung cancer is heterogeneity, and the rapid rise is the characteristic growth curve of malignant pulmonary nodules, but some of the growth curves can be flat, slowly rising or even decreasing in a certain period of time. Slow growth does not rule out lung cancer, especially subsolid nodules.
【作者单位】： 天津医科大学总医院医学影像科;贵州省人民医院核医学科;天津医科大学总医院病理科;
【基金】：国家自然科学基金面上项目(No.81171345) 中央补助地方公共卫生专项资金肺癌早诊早治项目 2012年高等学校博士学科点专项科研基金(No.20121202110005)资助~~
【分类号】：R734.2
，
本文编号：2377033
[Abstract]:Background & objective to evaluate the growth characteristics of pulmonary nodules by computed tomography (computed tomography,CT) follow-up is a common strategy in clinical diagnosis of benign and malignant nodules. Pulmonary nodules with different biological behaviors may have different growth rates and patterns. The purpose of this study was to draw the volume growth curves of different types of pulmonary nodules, to understand their growth patterns, and to provide evidence for judging the nature of nodules and making follow-up plans for lung nodules. Methods the imaging data of 111 cases of pulmonary nodules (54 solid nodules and 57 subsolid nodules) which underwent CT examination twice or more were analyzed retrospectively. 35 cases of malignant nodules and 5 cases of benign nodules were confirmed by pathology or histology. The other 71 cases were diagnosed as low risk nodules of lung cancer after two-year follow-up. All nodules were classified according to density and nature: solid benign / low risk nodules, solid malignant nodules, subsolid benign / low risk nodules, subsolid malignant nodules. The linear and exponential growth curves were drawn using (d) as X axis and mm3 and logarithm of 3D volume as Y axis. The shape of the curve was observed subjectively. Chi-square test was used to compare the difference of growth curves among different types of pulmonary nodules. In 12 cases (66.7%), the growth curve of fruit bearing malignant nodules increased rapidly, 3 cases (16.7%) were flat first and then increased, 2 cases (11.1%) slowly increased, and 1 case (5.56%) was straight. Among the subsolid malignant nodules, 8 cases (47.1%) showed a rapid upward pattern, 4 cases (23.5%) slowly increased, 3 cases (17.6%) were flat, and 2 cases (11.8%) showed the first descending and then ascending type. In 5 cases (13.9%) of solid benign / low risk nodules, 17 cases (47.2%) were flat, 8 cases (21.6%) were slowly ascending, and 6 cases (16.7%) were wavy. Of the subsolid benign / low risk nodules, 4 cases (10%) showed descending type, 21 cases (52.5%) were flat, 9 cases (22.5%) increased slowly, and 6 cases (15%) were wavy. There was significant difference in the distribution of growth curve between benign and low risk nodules and malignant nodules (蠂 2 / 42.4 P 0.01). Conclusion the growth curve of lung cancer is heterogeneity, and the rapid rise is the characteristic growth curve of malignant pulmonary nodules, but some of the growth curves can be flat, slowly rising or even decreasing in a certain period of time. Slow growth does not rule out lung cancer, especially subsolid nodules.
【作者单位】： 天津医科大学总医院医学影像科;贵州省人民医院核医学科;天津医科大学总医院病理科;
【基金】：国家自然科学基金面上项目(No.81171345) 中央补助地方公共卫生专项资金肺癌早诊早治项目 2012年高等学校博士学科点专项科研基金(No.20121202110005)资助~~
【分类号】：R734.2
，
本文编号：2377033
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