临床外科杂志 ›› 2020, Vol. 28 ›› Issue (9): 841-844.doi: 10.3969/j.issn.1005-6483.2020.09.014

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实性影/占位总径比率在肺多发性磨玻璃样结节术后的预后价值

  

  1. 210029 南京医科大学附属脑科医院(胸科院区)胸外科
  • 出版日期:2020-09-20 发布日期:2020-09-20
  • 通讯作者: 马国栋,Email:leon18982127411@163.com

Predictive value of CTR in patients with multiple ground-glass opacity (GGO) nodules

  1. Department of Thoracic Surgery,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China
  • Online:2020-09-20 Published:2020-09-20

摘要: 目的 评估术前胸部HRCT的实性影/占位总径比率(CTR)在肺部多发磨玻璃影(GGO)手术病人的预测价值。
方法 N0期肺癌手术切除病人91例,以CTR=0.5为截值,将病人分为GGO组和实性结节组,比较两组病人的临床和病理特征以及2年无复发生存率(RFS)的差异。
结果 91例病人中,共35例(38.5%)病人影像学表现为多发GGO结节。GGO组最大肿瘤直径小于实性结节组(10.2mm vs 21.6mm),差异有统计学意义(P<0.05)。COX多因素回归分析显示,肿瘤直径≥20mm和结节类型为实性(CTR≥0.5)的结节是RFS的独立预测因子。Kaplan-Meier生存曲线分析显示GGO组病人的RFS为91.4%,而实性结节组的RFS为75.0%,差异有统计学意义(P<0.05)。
结论 HRCT显示的CTR值是多发性GGO病人随访和治疗的参考指标之一,CTR值>0.5时外科干预更有价值。

关键词: 肺癌, 磨玻璃影, 多发结节, 实性影/占位总径比率, 手术

Abstract: Objective To assess the predictive value of preoperative chest HRCT consolidation/tumor ratio (CTR) in patients with multiple ground-glass opacity (GGO).
Methods A total of 91 patients with N0 stage lung cancer were enrolled.The patients were divided into GGO group and solid nodule group by CTR=0.5.The difference of clinical and pathological features and 3-year recurrence survival rate (RFS) of the two groups were compared.
Results Among the 91 patients enrolled,35 (38.5%) had multiple GGO nodules.The maximum diameter of the GGO group was significantly smaller than that of the solid nodules group (10.2mm vs 21.6mm,P<0.05).COX multivariate regression analysis showed that tumors≥20mm (HR:1.22,P=0.043) and solid nodules (CTR≥0.5) were independent predictors of RFS.Kaplan-Meier survival curve analysis showed that the RFS of the GGO group was 91.4%,while the RFS of the solid nodule group was 75.0%.There was a significant difference between the two groups (P<0.05).
Conclusion The CTR value displayed by HRCT is an effective reference for follow-up and treatment of patients with multiple GGO.Surgical intervention is the preferred treatment when CTR is greater than 0.5.

Key words: lung cancer, ground-glass opacity, multifocal lesions, consolidation/tumor ratio, surgery

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