A Comparative Study Of HRCT And Pathology In Cystic Lung Cancer

Background In recent years,with air pollution and industrial development,as well as with the progress of society and people’s emphasis on health,more and more patients with early lung cancer have been diagnosed.According to statistics,lung cancer has become the first malignant disease.Tumor.Due to the rapid development of medicine,there are a variety of clinical examination methods,which provide convenient adjustments for the diagnosis and treatment of diseases,especially high resolution computed tomography(HRCT)and multislice spiral computed tomography,The application of MSCT has greatly improved the accuracy of clinical and imaging physicians in the diagnosis of lung cancer.Through the interpretation and reflection of a large number of lung cancer imaging and pathology,there is a special type of lung cancer that has attracted attention—— Cystic lung cancer.Because this type of lung cancer is relatively rare,the clinical incidence is significantly lower than that of ordinary lung cancer,and there are few reports in domestic and foreign literature.Therefore,there is no uniform name for this type of lung cancer at present.Physiology lacks a correct understanding,so its missed diagnosis rate and misdiagnosis rate are both high.Objective Through clinical retrospective research,CT showed air-occupying space and was confirmed to be lung cancer by surgery and puncture pathology.The HRCT signs and pathological types of cystic lung cancer were analyzed for comparative studies to improve the HRCT of the clinicians.The recognition of the signs and the pathological basis of their formation,thereby improving the accuracy of clinical diagnosis.Methods This study is a retrospective study and included 87 patients with cystic lung cancer who were pathologically confirmed in the Department of Thoracic Surgery of the First Affiliated Hospital of Dalian Medical University from October 2018 to February 2021.Collect clinical data,perform HRCT examination on all subjects,and obtain pathological results through surgery/puncture,summarize the clinical data,HRCT signs,and pathological types of patients for comparative analysis.Results 1.From October 2018 to February 2021,87 patients with cystic lung cancer who were confirmed by thoracic surgery and puncture pathology in the First Affiliated Hospital of Dalian Medical University were the research objects.Among them,49 were males(56.3%)and38 were females(43.7%),with males slightly higher than females.Among them,with 60 years old as the boundary,33 cases(37.9%)younger than 60 years old,54(62.1%)older than 60 years old,the age of onset is mainly elderly.The maximum diameter of the tumor was 2.10±1.0095(0.5-5.5cm).Among them,there were 22 cases(25.3%)in the right upper lobe,1 case(1.1%)in the right middle lobe,18 cases(20.7%)in the right lower lobe,31 cases(35.6%)in the left upper lobe,and 15 cases(17.2%)in the left lower lobe.2.Among them,6 patients(6.8%)underwent needle biopsy without surgery,23 patients(26.4%)underwent thoracoscopic partial lobectomy,50 patients(57.5%)underwent thoracoscopic lobectomy,and 8 patients(9.2%)underwent thoracic cavity Endoscopic segmentectomy.The pathological results were: 3 cases of carcinoma in situ(3.4),10 cases of microinvasive carcinoma(11.5%),60 cases of adenocarcinoma(69.0%),7 cases of squamous cell carcinoma(8.0%),and other types of cancer(7 cases,8.0%).Among them,other types of cancer include mucinous adenocarcinoma2,small cell lung cancer in 1 case,malignant mesothelioma in 1 case,poorly differentiated adenocarcinoma cannot be determined in adenocarcinoma or squamous cell carcinoma in 1 case,pleomorphic carcinoma(spindle cell carcinoma + squamous cell carcinoma)Carcinoma + adenocarcinoma)in 1 case and large cell carcinoma in 1 case.3.Among 87 patients,the size of the lesion was 0.5-5.5cm,including 23 cases(26.4%)with lobular sign,31 cases(35.6%)with burr sign,40 cases(46.0%)with pleural depression sign,and 33 cases(37.9%)with vascular cluster sign.For this type of lung cancer,the cyst cavity is bound to exist inside or outside the lesion.Among them,62 cases(71.3%)of single cysts,25cases(28.7%)of multiple cysts,54 cases(62.1%)of round/quasi-circular cysts,33 cases(37.9%)of irregular shape cysts,with uniform thickness of the cyst wall 29 cases(33.3%),58 cases(66.7%)with uneven thickening,61 cases(70.1%)with smooth cyst wall,26 cases(29.9%)with roughness,24 cases(27.6%)with internal compartments,and 10 cases with wall nodules(11.5%).Conclusions Cystic lung cancer is a type of lung cancer with a low incidence.After HRCT scans of the chest,after excluding bullae,localized emphysema and other benign diseases that indicate air-bearing lesions on CT,you should be wary of this disease.Especially when there are nodules with different densities around the lesion with air space,the possibility of cystic lung cancer should be considered.When we observe the characteristics of peripheral lung cancer on HRCT images,such as lobular sign,burr sign,pleural depression sign,vascular cluster sign,etc.,it can be basically considered as the possibility of cystic lung cancer.Regarding the incidence,gender and age of cystic lung cancer,most of them were discovered unintentionally,and a small number of patients were in regular follow-up.The HRCT images changed,such as ground-glass nodules with air cavities.The interstitial structure,originally only manifested as simple airbearing lesions,gradually begins to consolidate.Most of the pathological stages are stage I and II,a very small number of stage III,occasionally stage IV,and the most common pathological type is adenocarcinoma,which is also seen Squamous cell carcinoma,mucinous adenocarcinoma,and precancerous lesions.Pathological subtypes are mostly acinar type and adherent growth type,a few are papillary type,micropapillary type and solid type,and most of the pathological subtypes are mixed.