近日，中科院深圳先進技術研究院生物醫(yī)藥與健康工程所醫(yī)學成像研究中心副研究員張麗娟在非實性肺癌腫瘤負荷的定量研究方面取得進展,，發(fā)現其腫瘤的影像密度值每增加100單位,，腫瘤負荷約增加10%。研究成果發(fā)表在國際期刊《放射學》（Radiology）雜志上,。
據介紹,，倍增時間在判斷腫瘤的性質及預后方面有重要臨床意義。 不同于實性腫瘤,，非實性肺癌在體積增加之前常存在一段不確定的“內生長”期,，即腫瘤組織向肺泡內空間填充，組織學上表現為癌細胞沿肺泡表面的增殖，而腫瘤的徑線并無改變,。 這種生長方式使得經典倍增時間計算方法不再適用,，長期以來該疾病的臨床診療也因此頗受困擾。
醫(yī)學影像技術的發(fā)展使得使用計算機輔助斷層成像在體估算腫瘤負荷成為可能,。 深圳先進院的這項研究結合應用醫(yī)學病理及影像的方法,，全面分析了非實性肺癌的內生長模式，并對其腫瘤負荷作了定量分析,，首次發(fā)現腫瘤的影像密度值每增加100單位,，腫瘤負荷約增加10%。
據介紹,，這項研究為非實性肺腫瘤的生長提供了有效的評估方法,，對肺癌的診療有重要臨床應用價值。 同時,，也為豐富肺癌的WHO（世衛(wèi)組織）分期提供了新思路,。（生物谷Bioon.com）
doi:10.1148/radiol.11101372
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Internal Growth of Nonsolid Lung Nodules: Radiologic-Pathologic Correlation
Lijuan Zhang, MD, David F. Yankelevitz, MD, Darryl Carter, MD, Claudia I. Henschke, PhD, MD, Rowena Yip, MPH and Anthony P. Reeves, PhD
Purpose: To determine whether computed tomographic (CT) attenuation values correlate with the histologic measurements of a lung cancer manifesting as a nonsolid nodule and to quantify the extent to which the tumor replaces the airspace within the nodule.
Materials and Methods: Informed consent was obtained to analyze images from CT and pathologic examination under an institutional review board–approved protocol. Fifteen patients who had undergone resection of nonsolid lung cancer were evaluated. On the basis of the CT attenuation values of nonsolid nodules, nonneoplastic lung, soft tissue, and air, the overall proportion of soft tissue in the nodule and nonneoplastic lung and the difference between these two measures were calculated. The analogous measures were obtained from a representative digitized histologic slide. The area of each nodule and the proportion of air within it were measured, and the proportion of soft tissue in the nodule and nonneoplastic lung and the difference between the two were calculated. The difference between the two proportions at CT and histologic examination are the proportions attributable to the cancer on the basis of CT and histologic examinations, respectively. Linear regression was performed to assess the relationship between these measures.
Results: The average proportions of soft tissue in the nodule at CT and histologic examination were 48% and 69%, respectively, and they showed significant correlation with each other (P = .02); in addition, each showed significant correlation with the attenuation of the nodule (P < .0001 and P = .02, respectively). The difference between the proportions of soft tissue in nodule and nonneoplastic lung at CT and histologic examination were 37% and 30%, respectively, and both were independent of the tumor diameter (P = .26 and P = .41).
Conclusion: The proportion of soft tissue within a nonsolid nodule is correlated with attenuation at CT. This allows for measurement of change within the nodule. An increase of 100 HU in nodule attenuation represents an approximately 10% increase in tumor volume.
