摘要目的:探讨高分辨CT诊断早期肺腺癌的应用价值。方法:回顾性分析衢州市人民医院2021年1-12月诊治的早期肺腺癌患者90例的临床资料，依据浸润与否分为非浸润组（ n=27）、浸润组（ n=63）。非浸润组中，非典型腺瘤样增生10例，原位腺癌17例；浸润组中，微浸润性腺癌（MIA）38例，浸润性腺癌（IAC）25例。均经病理学检查证实，且行高分辨CT检查。比较不同部位肺腺癌患者发生情况，比较非浸润组与浸润组病灶CT征象，采用受试者工作特征（ROC）曲线鉴别诊断浸润前病变敏感度和特异度。 结果:非浸润组与浸润组左肺上叶、右肺上叶、左肺下叶和右肺下叶肺腺癌检出率差异均无统计学意义（均 P > 0.05）。浸润组胸膜凹陷征［28.6%（18/63）］、毛刺征［31.57%（20/63）］和血管集束征［27.0%（17/63）］检出率均高于非浸润组的7.41%（2/27）、11.11%（3/27）、7.41%（2/27）（χ 2=4.90、4.23、4.35，均 P < 0.05）；两组分叶征、空气支气管征检出率差异均无统计学意义（均 P > 0.05）。ROC曲线分析显示，高分辨CT鉴别浸润前病变敏感度为100.0%，特异度为64.7%。 结论:高分辨CT对早期肺腺癌诊断价值良好，早期肺腺癌各种征象可更清晰地显示，值得临床借鉴。

abstractsObjective:To investigate the application value of high-resolution CT in the diagnosis of early lung adenocarcinoma.Methods:The clinical data of 90 patients with early lung adenocarcinoma who received treatment from January to December 2021 in Quzhou People's Hospital were retrospectively analyzed. These patients were divided into a non-invasive group ( n = 27) and an invasive group ( n = 63) according to whether they had invasive lung adenocarcinoma or not. In the non-invasive group, there were 10 patients with atypical adenomatous hyperplasia and 17 patients with in situ adenocarcinoma. In the invasive group, there were 38 patients with minimally invasive adenocarcinoma and 25 patients with invasive adenocarcinoma. A pathological diagnosis was performed in all patients. All patients underwent a high-resolution CT examination. The incidence of lung adenocarcinoma was compared between different loci. CT signs were compared between the non-invasive group and the invasive group. The receiver operating characteristic curve was used to determine the sensitivity and specificity of high-resolution CT in the differential diagnosis of lung adenocarcinoma prior to invasion. Results:There was no significant difference in the incidence of lung adenocarcinoma among the left upper lobe, right upper lobe, left lower lobe, and right lower lobe of the lung in each group (all P > 0.05). The detection rates of pleural indentation sign, spicule sign, and vascular bundle sign in the invasive group were 28.6% (18/63), 31.57% (20/63), and 27.0% (17/63), respectively, which were significantly higher than 7.41% (2/27), 11.11% (3/27), and 7.41% (2/27) in the non-invasive group ( χ2 = 4.90, 4.23, 4.35, all P < 0.05). There were no significant differences in detection rates in the lobar sign and air bronchogram sign between the two groups (both P > 0.05). The receiver operating characteristic curve analysis results showed that the sensitivity and specificity of high-resolution CT in differentiating pre-invasive lesions were 100.0% and 64.7%, respectively. Conclusion:High-resolution CT has a good diagnostic value for early lung adenocarcinoma. It can clearly display various signs of early lung adenocarcinoma, which is worthy of clinical reference.