Correlation Between Clinical Characteristics, Radiological Findings, Pathological Findings, and Prognosis in Patients With a Peripheral Lung Adenocarcinoma Less Than 15mm in Diameter
作者： Toshihiko Hashizume , Kouzo Yamada , Rie Suzuki , Haruhiro Saito , Fumihiro Oshita
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摘要: 目的. 径15 mm以下の肺癌の多くはCTにより発見されており, 今後CT検診が普及するとそれが増加すると予想される. 今回15 mm以下の肺腺癌を対象に, 組織形態と臨床背景の関連, および画像所見と病理, 予後の関連を明らかにすることを目的に研究を行った. 対象と方法. 1992年から2003年までに当院で切除された径15 mm以下の肺腺癌160例を対象とした. 野口分類と性別, 喫煙の関連を解析した. Thin-section CT (TS-CT) により病変を含気型, 充実型に分類し, おのおので病理所見, 予後の差を解析した. 結果. 野口分類type A, Bはtype Cに比べて女性に多く認められた. D, E, Fはtype Cに比べて喫煙者に多く認められた. 含気型病変は充実型病変と比較して, リンパ節転移, 胸膜浸潤, 脈管浸潤が少なく, 切除予後が良好であった. 病期を含めた予後因子に関する多変量解析の結果では, TS-CT所見は独立した有意な予後因子とはならなかった (p=0.059). 結論. 性別や喫煙などの臨床背景により腺癌の組織形態に差があることが示唆された. TS-CT所見は予後因子としては示されなかったが, TS-CTを用いた画像分類により病理学的浸潤所見の少ない予後良好な腺癌を鑑別しうる可能性が示唆された.
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