CAJ | 학술논문

目的探讨肺局限性磨玻璃结节（GGN）的高分辨率CT（HRCT）征象与国际肺癌研究协会/美国胸科学会/欧洲呼吸学会病理的相关性。资料与方法选取121例GGN患者，按病理结果将其分为良性组（22例）、浸润前病变（PIL）组（21例）、微浸润癌组（26例）和浸润癌组（52例），总结患者肺GGN的影像、病理及预后资料，分析不同病理类型GGN间的差异。结果 GGN的最大径、边缘、空泡征、实性成分、形状及是否有血管穿行在4组间差异均有统计学意义（χ2=9.945~31.068， P<0.05）。浸润癌组的最大径、边缘与良性组、PIL组、微浸润癌组比较，差异有统计学意义（P<0.008）；良性组空泡征与PIL组、微浸润癌组、浸润癌组比较，差异有统计学意义（P<0.008）；是否含有实性成分、形状在浸润癌与微浸润组间差异有统计学意义（P<0.008）；是否有血管穿行在良性组与浸润癌组间差异有统计学意义（P<0.008）。仅1例浸润癌出现远处转移。结论当GGN的最大径≥16.35 mm、出现毛刺征或分叶征提示浸润癌；当GGN内部出现空泡征则提示其为恶性；GGN内部含有实性成分或其形状不规则，可以鉴别浸润癌与微浸润癌；GGN内部有血管穿行可以用于鉴别浸润癌与良性病灶；GGN的预后好，仅0.83%病例出现远处转移。
목적탐토폐국한성마파리결절（GGN）적고분변솔CT（HRCT）정상여국제폐암연구협회/미국흉과학회/구주호흡학회병리적상관성。자료여방법선취121례GGN환자，안병리결과장기분위량성조（22례）、침윤전병변（PIL）조（21례）、미침윤암조（26례）화침윤암조（52례），총결환자폐GGN적영상、병리급예후자료，분석불동병리류형GGN간적차이。결과 GGN적최대경、변연、공포정、실성성분、형상급시부유혈관천행재4조간차이균유통계학의의（χ2=9.945~31.068， P<0.05）。침윤암조적최대경、변연여량성조、PIL조、미침윤암조비교，차이유통계학의의（P<0.008）；량성조공포정여PIL조、미침윤암조、침윤암조비교，차이유통계학의의（P<0.008）；시부함유실성성분、형상재침윤암여미침윤조간차이유통계학의의（P<0.008）；시부유혈관천행재량성조여침윤암조간차이유통계학의의（P<0.008）。부1례침윤암출현원처전이。결론당GGN적최대경≥16.35 mm、출현모자정혹분협정제시침윤암；당GGN내부출현공포정칙제시기위악성；GGN내부함유실성성분혹기형상불규칙，가이감별침윤암여미침윤암；GGN내부유혈관천행가이용우감별침윤암여량성병조；GGN적예후호，부0.83%병례출현원처전이。
Purpose To evaluate the correlations between high resolution CT (HRCT) findings and IASLC/ATS/ERS pathological classification of ground glass nodule (GGN). Materials and Methods 121 patients with confirmed GGN were selected, and divided into benign group (22 cases), PIL group (21 cases), microinvasive carcinoma group (26 cases) and invasive carcinoma group (52 cases), then the imaging, pathology and prognosis data of patients with pulmonary GGN were reviewed, and the differences among GGN of different pathological types were analyzed.Results Maximum diameter, margin, vacuole sign, solid component, shape and blood vessels through of GGN were significantly different among the four groups (χ2=9.945-31.068,P<0.05). Maximum diameter and margin were significantly different between invasive adenocarcinoma and other groups (P<0.008); vacuole sign of the benign group was significantly different with other groups (P<0.008); the existence of solid component and shape were significantly different between invasive adenocarcinoma and minimally invasive adenocarcinoma (P<0.008); there was significant difference of blood vessels through between invasive adenocarcinoma and benign lesions (P<0.008). Among the 121 lesions, no metastasis except one invasive adenocarcinoma case complicated with distant metastasis.Conclusion Maximum diameter of GGN greater than 16.35 mm, with spiculation or lobulation represent invasive adenocarcinoma; vacuole sign within the GGN represent malignancy; with solid component and irregular shape can be used to identify invasive adenocarcinoma from minimally invasive adenocarcinoma; while blood vessels through can be used to identify invasive adenocarcinoma from benign lesions; the prognosis of GGNs is well with only 0.83% probability of distant metastasis.