CAJ | 학술논문

目的：分析周围型肺癌的支气管血管集束征CT表现，并结合病理改变探讨其形成机制和判断预后的价值。材料和方法：回顾性分析经手术和病理证实的170例周围型肺癌支气管血管集束征的CT表现和病理基础。依据数目和程度将支气管血管集束征的CT表现分为0～Ⅲ度，并对该征象在肺癌瘤体上的方位进行计数分析。结合各度支气管血管集束征与肺癌的大小、手术病理分期、病理改变的关系分析此征的形成机制和判断预后的价值。结果：①小于或等于10mm周围型小肺癌的绝大多数支气管血管集束征为0度。11mm以上周围型肺癌支气管血管集束征的程度加重，但是11～20mm和21mm以上组两组肺癌之间无明显差别。②随着肺癌病理分期的提高，重度支气管血管集束征的比例亦升高。③支气管血管集束征在肺癌瘤体的4个象限上均可出现，支气管气相以肺门区和外围区为多。结论：①肺癌瘤体内纤维化灶和肿瘤增殖破坏致使肺结构的塌陷皱缩是形成支气管血管集束征的基本原因。②血管集束征并非肺癌的供血血管和肿瘤血管。③支气管血管集束征的程度间接预示肺癌的恶性程度和预后。
목적：분석주위형폐암적지기관혈관집속정CT표현，병결합병리개변탐토기형성궤제화판단예후적개치。재료화방법：회고성분석경수술화병리증실적170례주위형폐암지기관혈관집속정적CT표현화병리기출。의거수목화정도장지기관혈관집속정적CT표현분위0～Ⅲ도，병대해정상재폐암류체상적방위진행계수분석。결합각도지기관혈관집속정여폐암적대소、수술병리분기、병리개변적관계분석차정적형성궤제화판단예후적개치。결과：①소우혹등우10mm주위형소폐암적절대다수지기관혈관집속정위0도。11mm이상주위형폐암지기관혈관집속정적정도가중，단시11～20mm화21mm이상조량조폐암지간무명현차별。②수착폐암병리분기적제고，중도지기관혈관집속정적비례역승고。③지기관혈관집속정재폐암류체적4개상한상균가출현，지기관기상이폐문구화외위구위다。결론：①폐암류체내섬유화조화종류증식파배치사폐결구적탑함추축시형성지기관혈관집속정적기본원인。②혈관집속정병비폐암적공혈혈관화종류혈관。③지기관혈관집속정적정도간접예시폐암적악성정도화예후。
Objective: To analyze the CT features of bronchovascular convergence sign in peripheral lung cancer, then to make a scientific approach to its mechanism and value in estimating prognosis of peripheral lung cancer. Materials and Methods: The CT features and pathological basis of bronchovascular convergence sign in 170 peripheral lung cancers proved by operation and pathology were analyzed retrospectively. According to number and grade the sign were divided into 0～Ⅲ degree The location of bronchovascular convergence sign in tumor were analyzed also. The relation between grade of bronchovascular convergence sign and size, stage, pathological changes of cancers were used to deduce mechanism of this sign, and to estimate prognosis of patients with lung cancer. Results: ① The vast majority of≤10mm small peripheral lung cancer had 0 dgree bronchovascular convergence sign,＞11mm peripheral lung cancer had more advanced bronchovascular convergence sign. No marked differences between 11～20mm and＞21mm peripheral lung cancer. ② Higher staged lung cancer had more advanced bronchovascular convergence sign ③ Bronchovascular convergence sign could occur any quarter of tumor, air-bronchogram more often in hilum quarter and peripheral quarter. Conclusion: ① Fibrosis and proliferation within peripheral lung cancer are fundamental cause formatting bronchovascular convergence sign ② Vascular convergence sign is not supply vessel and tumor vessel. ③ Bronchovascular convergence sign can be used to predict prognosis and malignance of peripheral lung cancer indirectly.