目的探讨微浸润腺癌(MIA)及浸 润性腺癌(IAC)CT征象与其瘤内纤维化相 关性。方法 回顾性分析42例肺腺癌43个 肺磨玻璃结节术前CT表现，采用半定量 对瘤内纤维化分级，采用秩和检验、卡 方检验分析MIA和IAC组间量化的胸膜凹陷 征、分叶征、毛刺征、异常血管和异常 支气管征与瘤内纤维化分级差异性，并 采用Spearman等级相关分析各CT征象与 瘤内纤维化分级相关性。结果 (1)分叶 征深度、胸膜凹陷征程度、毛刺征、异 常血管和支气管征数量在MIA与IAC组间 差异有统计学意义(P<0.05)；(2)瘤内纤 维化分级在MIA与IAC组间差异亦有统计 学意义(P<0.05)；(3)瘤内纤维化分级与 胸膜凹陷征程度(r=0.496，P<0.05)、分 叶征深度(r=0.440，P<0.05)、毛刺征数 量(r=0.305，P<0.05)、异常血管征数量 (r=0.372，P<0.05)均呈显著正相关，与 异常支气管征数量(r=0.173，P>0.05)无 明显相关。结论 CT上胸膜凹陷征、分叶 征、毛刺征与异常血管征的数量程度可反 映肺腺癌瘤内纤维化程度，对术前鉴别诊 断MIA和IAC具有重要的临床参考价值。

Objective To investigate the correlation between CT features of MIA and IAC and fibrosis within tumors. Methods The preoperative CT images of 43 ground glass nodules in 42 lung adenocarcinomas were retrospectively analyzed. The fibrosis within tumors was graded semi-quantitatively. Pleural indentation and lobulation, spiculation, abnormal blood vessels, abnormal bronchi and interstitial fibrosis grade of tumor quantitatively between MIA and IAC were analyzed by rank-sum test and chi-square test. Spearman test was made to analyze correlation between CT features and interstitial fibrosis grade of tumor. Results (1) The extent of lobulation and pleural indentation ,the amount of spiculation, abnormal blood vessels and bronchi were statistically significant difference between MIA and IAC(P<0.05). (2)There were also significant difference in the terms of the degree of fibrosis within tumors between MIA and IAC(P<0.05). (3) The grade of fibrosis in tumor is significantly positively related to the extent of pleural indentation(r=0.496, P<0.05) and lobulation(r=0.440, P<0.05), the amount of spiculation(r=0.305, P<0.05) and abnormal blood vessels(r=0.372, P<0.05), there is no obvious correlation between the grade of fibrosis in tumor and the amount of abnormal bronchi(r=0.173, P>0.05). Conclusion The extent of pleural indentation and lobulation, the amount of spiculation and abnormal blood vessels on CT can reflect the grade of fibrosis in lung adenocarcinoma, which have important value of clinical application in the preoperative differential diagnosis of MIA and IAC.