【摘要】 目的 探讨三维平均CT值和PET/CT最大标准化摄取值（SUVmax）对磨玻璃密度结节（GGN）型肺腺癌侵袭性的预测价值。方法 回顾性分析经手术病理证实的81例表现为GGN的肺腺癌,均行PET/CT和HRCT检查。在病变最大直径的CT横断面上测量其平均直径（最大径和垂直径的均值）;逐层手动描绘出GGN的轮廓,计算GGN的三维平均CT值;记录¹⁸F-脱氧葡萄糖(¹⁸F-FDG)PET/CT的SUVmax。按照病理类型分为浸润前病变、微浸润腺癌、浸润性腺癌3组,并统计3组间肿瘤大小、三维平均CT值及SUVmax之间是否有统计学差异。结果 浸润前病变、微浸润腺癌和浸润性腺癌的肿瘤大小分别为（10.53±4.3）mm、（11.6±6.07）mm、（20.3±9.0）mm;三维平均CT值分别为（-568.59±128.7）HU、（-522±100.51）HU、（-321.9±165.2）HU;SUVmax分别为0.15±0.43、0.00±0.00、2.51±2.61,3组间差异有明显统计学意义（F值分别为11.06、18.624、9.06,P<0.001）。受试者工作特征曲线（ROC）显示,肿瘤大小、三维平均CT值、SUVmax的诊断价值中等,曲线下面积（AUC）分别为0.855、0.867、0.895。三者分别取最佳临界值11.5 mm、-486 HU、0.95,其相对应的诊断浸润性病变的敏感度分别为91.5%、83.1%、79.7%;特异度分别为68.2%、77.3%、95.5%。结论 肿瘤大小、三维平均CT值、SUVmax是判断GGN型腺癌侵袭性的重要预测因子。更多还原

【Abstract】 Objective To evaluate the three-dimensional mean computed tomography value and maximum standardized uptake value(SUVmax) of patients with pulmonary ground-glass nodules(GGNs) to identify factors predictive of pathological invasion.Methods 81 pulmonary GGNs resected that pathologically confirmed as adenocarcinoma were evaluated retrospectively.All the patients underwent 18F-FDG PET/CT and HRCT examinations.The largest transverse sectional diameters of the tumor were measured.The three-dimensionalmean CT value was measured using the region-of-interest cursors,which traced the edge of the tumor on all slices.Then the SUVmax of the main tumor was also assessed.All the cases were divided into 3 groups according to pathological classifications:Pre-invasive lesions(included atypical adenomatous hyperplasia and adenocarcinoma in situ),minimally invasive adenocarcinoma(MIA) and invasive adenocarcinoma.Then the tumor size,three-dimensional mean CT value and SUVmax were compared among the 3 groups.Results The tumor size,threedimensional mean CT value and SUVmax of the three groups were(10.53±4.3) mm,(11.6±6.07) mm,(20.3±9.0)mm,(-568.59±128.7) HU,(-522±100.51)HU,(-321.9±165.2)HU and(0.15±0.43),(0.00±0.00),(2.51±2.61),respectively.Significant differences among the three groups were observed.In ROC curve analyses,the sensitivity and specificity of tumor size(cut off,11.5 mm) were 91.5% and68.2%,respectively.And those for three-dimensional mean CT value(cut off,-486 HU) were 83.1% and 77.3%,respectively.Those for SU V max(cut off,0.95) were 79.7%and 95.5%,respectively.The area under the curve(AUC) were0.855,0.867 and 0.895,respectively.Conclusion Tumor size,three-dimensional mean CT value and SUVmax are predictive factors of pathological invasiveness for pulmonary GGNs.更多还原