【作者】 王军；

【导师】 姜杰；

【作者基本信息】 厦门大学 ， 外科学， 2019， 硕士

【摘要】 目的探索肺部恶性纯磨玻璃结节的临床、影像特征与其病理组织学特征之间的联系。方法收集2017年1月至2018年12月在厦门大学附属第一医院胸外科行手术治疗的纯磨玻璃结节的患者的临床数据。结果共有58例病人、65个纯磨玻璃结节纳入研究。术后不同TNM分期的病人之间,性别(p=0.034)、有糖尿病或慢性呼吸系统疾病史(p=0.037)、年龄(p=0.038)这3个临床特征存在显著性差异,而吸烟史、个人恶性肿瘤史、家族恶性肿瘤史、家族肺癌史、结节的数目、肿瘤标志物5项无显著性差异;不同病理组织学分型的pGGN中,结节的直径(p<0.001)、最大CT值(p=0.002)、形状是否为类圆形(p=0.044)、血管异常或血管集束征(p<0.001)、空泡征或空气支气管征(p=0.026)、纵隔淋巴结肿大(p=0.028)、血管穿行或穿入(p=0.030)等7项影像学特征具有统计学差异,而结节的位置、边界是否清楚、毛刺征、胸膜牵拉或胸膜凹陷没有显著性差异。结论pGGN病人中性别差异、有糖尿病或慢性呼吸系统疾病史、年龄>66±8.49岁会增加其结节恶性风险;结节的大小、形态、密度、周围血管的异常改变、纵隔淋巴结有无肿大等影像学特征是区分其病理组织学类型的重要因素。更多还原

【Abstract】 Objective To explore the relationship between clinical and imaging features and histopathological features of malignant pure ground glass nodules in the lung.Methods The clinical data of patients with purely ground glass nodules who underwent surgical treatment of thoracic surgery at the First Affiliated Hospital of Xiamen University from January 2017 to December 2018 were collected.Results A total of 58 patients and 65 purely ground glass nodules were included in the study.There were significant differences in the three clinical features of gender(p=0.034),diabetes or chronic respiratory disease(p=0.037),and age(p=0.038)between patients with different TNM staging,and smoking history.There were no significant differences in the history of individual malignant tumors,family history of malignant tumors,family history of lung cancer,number of nodules,and tumor markers.The diameter of nodules(p<0.001)and maximal in pGGN with different histological types.CT value(p＝0.002),whether the shape is round-like(p＝0.044),vascular abnormality or vascular bundle sign(p<0.001),vacuole sign or air bronchus sign(p=0.026),mediastinal lymphadenopathy(Seven imaging features,such as p=0.028),vascular transit or penetration(p＝0.030),were statistically different,and there were no significant differences in the location or boundary of the nodules,burr signs,pleural traction,or pleural indentation.Conclusion Women with pGGN who have a history of diabetes or chronic respiratory disease and age>66±8.49 years will increase the risk of malignant nodules;the size,shape,density of the nodules,abnormal changes of peripheral blood vessels,swelling of the mediastinal lymph nodes,etc.Imaging features are important factors that distinguish the type of histopathology.更多还原