Differential CT diagnosis between early peripheral adenocarcinoma and squamous cell carcinoma of the lung

WANG Huiying; QIANG Jun; CHEN Diansen

doi:10.20258/j.cnki.1006-9011.2025.03.011

Abstract：Objective The main points of differential diagnosis between early peripheral lung squamous cell carcinoma and early peripheral lung adenocarcinoma were compared to improve the accuracy of CT diagnosis.Methods The CT and pathologi-cal data of 173 patients with early peripheral non-small cell lung cancer confirmed by pathology were retrospectively collected.The CT features of early peripheral solid non-small cell lung cancer(49 cases of squamous cell carcinoma and 42 cases of adeno-carcinoma)were compared,including lung background,lesion size,morphology,axial orientation,lobulation,spiculation,pleural indentation sign,vascular convergence sign,vascular bundle thickening,air bronchogram,as well as bronchial wall change and necrosis.Chi-square test was used to analyze the CT signs of the two groups.Results There were more female pa-tients with lung adenocarcinoma by statistical analysis.All the early peripheral lung squamous cell carcinoma were solid foci.There were 42 solid lesions,50 mixed ground-glass lesions,and 32 ground glass lesions in early peripheral lung adenocarci-noma.Compared with early solid lung adenocarcinoma,squamous carcinoma was more likely to present with emphysema,consis-tent with the bronchial long axis,and corresponding bronchial tube wall thickening and necrosis(P<0.05).Adenocarcinoma was more likely to have air bronchogram and pleural indentation sign(P<0.05).No significant difference was observed in lobula-tion,spiculation and vascular convergence sign(P>0.05).Subsolid lung adenocarcinoma was more prone to vascular bundle thickening sign(P<0.05).Conclusion CT scan may help to quickly distinguish early peripheral lung adenocarcinoma and lung squamous cell carcinoma,and improve the accuracy of imaging diagnosis.