目的 比较周围型非小细胞肺癌 (NSCLC)侵袭性预测的三种CT影像学参 数。方法 回顾性分析156例周围型NSCLC 患者术前高分辨CT(high resolution CT，HRCT)，测量肿瘤最大直径(whole nodule diameter，D)，实性成分最大径 (S，solid area)及磨玻璃成分(glassground opacity，GGO)比率(GGO比率根据 GGO的量化公式:[(GGO最大径-实性最大 径)/GGO最大径]×100%进行计算),比较各 参数与术后病理侵袭性之间的相关性，运 用ROC曲线评估不同参数对侵袭性评价的 敏感性、特异性，并通过卡方检验分层比 较最佳界值。低侵袭性定义为无血管、胸 膜、淋巴管浸润及淋巴结转移。结果 156 例患者(男性58例，女性98例，平均年龄 63岁)中，腺癌138例。156例中病理为低 侵袭性患者共35例。ROC曲线分析三种评 估侵袭性的影像学参数得出，GGO有最高 的特异度和敏感度(曲线下面积：0.823； 95%CI：0.801-0.786)，其次为S值(曲线 下面积：0.782；95%CI：0.734-0.825)， 最后为D值(曲线下面积：0.623，95%CI： 0.564-0.678)。实性成分小于5mm及GGO比 率大于80%提示低侵袭性。结论 GGO比率 及实性成分直径在预测低侵袭性非小细胞 肺癌中有重要价值。

Objective To compare three CT parameters in predicting the invasiveness of less invasive peripheral non-small cell lung cancer. Methods 156 peripheral patients with NSCLC were analyzed retrospectively. The maximum diameter of nodule, solid area diameters as well as proportion of GGO diameters to solid area diameters[(GGO diameters-solid area diameters)/GGO diameters]×100% were abtained. The correlation between each parameters and pathological invasiveness were also explored. Using receiver operating characteristic (ROC) curve to analysis the sensitivity and specificity of three parameters in predicting less invasive lung cancer. Less invasive lung cancer was defined as those having no vascular, lymphatic, or pleural invasion or lymph node metastasis. Results 156 patients (58 male, 98 female, mean age 63 years old) were enrolled. 138 were adenocarcinoma. ROC analysis showed that the area under the curve of proportion of GGO was the highest (0.823; 95% confidence interval [CI], 0.801-0.786), followed by the solid area diameter (0.782; 95% CI, 0.734-0.825), and then whole nodule diameter (0.623; 95% CI, 0.564-0.678). Conclusion Proportion of GGO and the solid area diameter have important value for predicting invasiveness of less invasive lung cancer.