赵传民 王素红

摘要：目的：探究CT與X线胸片诊断鉴别肺部良性肿瘤与肺癌的应用价值。方法：对院内120例疑似肺癌患者临床资料进行回顾性分析，通过病理活检或术后检查确诊良性肿瘤54例，肺癌66例。所有患者术前行CT与X线胸片放射检查，将病理活检结果作为标准，观察不同检查方式诊断符合率。结果：X线胸片检查符合率75.76%，CT诊断为90.91%;良性肿瘤X线胸片诊断符合率62.96%，小于CT检查的92.59%，两组间对比差异有统计学意义（P<0.05）。CT检查灵敏度90.91%，特异度92.59%，准确度91.67%;X线胸片检查灵敏度75.76%，特异度62.96%，准确度70.00%，两组间对比差异有统计学意义（P<0.05）。X线胸片诊断边缘不规则或分叶征、周围型孤立性结节状病灶、全肺或肺叶一侧不张等检出率均低于CT诊断结果，两组间对比差异有统计学意义（P<0.05）。结论：与X线胸片放射诊断方式对比，CT鉴别肺部良性肿瘤与肺癌的精准度及灵敏度更高。

关键词：CT;X线胸片;肺部良性肿瘤;肺癌;鉴别诊断

中图分类号：R730.44文献标识码：ADOI：10？郾3969/j.issn.1001-0270.2021.05.07

Effect of CT and X-ray Chest Radiography in Differentiating Benign Lung Tumors from

Lung Cancer

ZHAO Chuan-min1， WANG Su-hong2

（1. Department of Radiology， Xiaozhi Town Central Hospital， Pingyin County， Shandong 250402， China; 2. Department 1， Xiaozhi Town Central Health Center， Pingyin County， Shandong 250402， China）

Abstract： Objective： To explore the application value of CT and chest X-ray radiography in differentiating benign lung tumors from lung cancer. Methods： Clinical data of 120 suspected patients with lung cancer in hospital were retrospectively analyzed. 54 cases of benign tumor and 66 cases of lung cancer were confirmed by pathological biopsy or postoperative examination. All patients received preoperative CT and chest X-ray radiography， and pathological biopsy results were taken as the standard to observe the diagnostic coincidence rate of different examination methods. Results： The coincidence rate of chest X-ray examination was 75.76% and CT diagnosis was 90.91%. The diagnostic coincidence rate of benign tumor by chest X-ray was 62.96%， which was lower than that of CT examination （92.59%）， and the difference between the two groups was statistically significant （P<0.05）. The sensitivity， specificity and accuracy of CT were 90.91%， 92.59% and 91.67%. The sensitivity， specificity and accuracy of chest X-ray examination were 75.76%， 62.96% and 70.00%， and the difference between the two groups was statistically significant （P<0.05）. The detection rates of marginal irregularity or lobulation sign， peripheral isolated nodular lesions， whole lung or one lobe atelectasis were all lower than the results of CT diagnosis， and the difference between the two groups was statistically significant（P<0.05）. Conclusion： Compared with the radiation diagnosis of X-ray chest tablets， CT has higher accuracy and sensitivity between benign lung tumors and lung cancer.

Key Words： CT; Chest radiograph; Benign lung tumor; Lung cancer; The differential diagnosis

肺癌即肺部组织恶性肿瘤，病情发展快，致死率较高。而肺良性肿瘤生长速度慢，较少复发，对机体健康威胁相对较小，但存在转变为恶性肿瘤的风险[1]。肺癌发病机制复杂，病因未明确。综合大量临床实践及研究结果认为，过度吸烟与环境污染对于肺癌的发生具有促进作用[2]。肺癌早期可通过手术治疗，若发展到晚期则会失去手术治疗机会。因此，对肺癌的早期诊断对于改善患者预后具有重要意义。针对肺部肿瘤的良恶性性质鉴别至关重要，可为后续治疗提供参考，对于降低良性肿瘤风险也具有积极作用。肺部良性肿瘤发生在肺外周者无症状;若处在主支气管或肺叶支气管，早期以咳嗽为主要症状，肿瘤较大者可导致管腔狭窄。症状表现及发展规律与恶性肿瘤之间无明显差异，难以通过症状表现进行肿瘤性质判断[3]。临床中针对肺部良性肿瘤与肺癌主要采用影像学检查技术，常用CT与X线胸片检测技术。……