CAJ | 학술논문

目的：分析青年人群肺腺癌CT影像学表现特点及病理。方法回顾性分析2012年1月~2013年6月经临床病理确诊为原发性肺腺癌57例患者的临床、影像学资料及病理结果。结果从出现症状到明确诊断平均时间为（3.6±0.4）个月。16例（28%）误诊或延误诊疗。57例肺腺癌中，表现为中央型4例，周围型52例，弥漫型1例；多原发肺癌2例。肺内原发灶表现为肿块和结节的46例，其中磨玻璃结节2例，其余为实性。出现分叶征39例，毛刺征29例，胸膜凹陷征27例。可判断病理分化程度的51例，其中原位腺癌1例，微浸润腺癌1例，浸润型腺癌中高分化腺癌4例，中高分化2例，中分化14例，中低分化9例，低分化20例。确诊时已发生转移44例，胸部转移共38例，胸腔积液14例。结论青年肺腺癌以周围型为主，CT主要表现为肿块、结节，分化程度差，多数病例确诊时已发生转移，误诊及延误诊疗多见。
목적：분석청년인군폐선암CT영상학표현특점급병리。방법회고성분석2012년1월~2013년6월경림상병리학진위원발성폐선암57례환자적림상、영상학자료급병리결과。결과종출현증상도명학진단평균시간위（3.6±0.4）개월。16례（28%）오진혹연오진료。57례폐선암중，표현위중앙형4례，주위형52례，미만형1례；다원발폐암2례。폐내원발조표현위종괴화결절적46례，기중마파리결절2례，기여위실성。출현분협정39례，모자정29례，흉막요함정27례。가판단병리분화정도적51례，기중원위선암1례，미침윤선암1례，침윤형선암중고분화선암4례，중고분화2례，중분화14례，중저분화9례，저분화20례。학진시이발생전이44례，흉부전이공38례，흉강적액14례。결론청년폐선암이주위형위주，CT주요표현위종괴、결절，분화정도차，다수병례학진시이발생전이，오진급연오진료다견。
Objective To describe CT features and tumor cell differentiation in pathology in adenocarcinoma of lung in young patients. Methods The clinical data and CT findings of lung adenocarcinoma proved pathologically in 57 young patients were reviewed. Results The average duration from symptom onset to diagnosis was (3.6±0.4) months. 16 cases were misdiagnosed. There were 4 patients with central bronchogenic carcinoma, 52 with peripheral bronchogenic carcinoma, 1 with diffuse bronchial carcinoma (DBC) and 2 with multiple primary bronchial carcinomas (MPBC), 46 cases presented as masses and nodules and 39 with lobulation, 29 with speculation and 27 with pleural indentation. There were 51 patients with discernible degree of cancer differentiation, 1 case with AIS, 1 with minimally invasive adenocarcinoma, among invasive adenocarcinoma, 4 with high differentiation, 2 with high-moderate differentiation, 14 with moderate differentiation, 9 with low-moderate differentiation and 20 with low differentiation. Most of the cases were advanced stage when diagnosed, 44 presented with metastasis, 38 patients with chest metastasis, pleural effusion occurred in 14 patients. Conclusion Peripheral mass and nodule are the predominant CT features of lung adenocarcinoma in young patients. Poor-differentiated tumor with metastasis is common when diagnosed.