a in situ,AIS)Р影像学:典型表现为纯GGN,偶为实性结节。大小不一,大多数小于2cm。Р预后:生长缓慢,临床上不需要立即干预。对于小于1cm的AIS通常至少一年随访一次,当病变增大或密度增高,提示可能进展为浸润性癌。如最初病变较小,随访中病变增大至1cm以上时,需密切随访,建议半年或一年做一次CT检查。Р微浸润性腺癌(minimally invasive adenocarcinoma,MIA)Р定义:肿瘤细胞明显沿肺泡壁生长的孤立性, ≤3cm的小腺癌,伴病变内1个或多个≤ 0.5cm浸润灶。多个浸润灶以直径最大的为准。?浸润判断标准:1、除了沿肺泡壁生长外,见到其他类型的成分(腺泡、乳头、微乳头和实性)。2、癌细胞浸润到肌纤维母细胞性间质中。3、但出现淋巴管、血管或胸膜侵犯以及出现肿瘤性坏死时,应直接诊断为浸润性腺癌。Р微浸润性腺癌(minimally invasive adenocarcinoma,MIA)РB, To the left is the lepidic pattern and on the right is an area of acinar invasion. C, These acinar glands are invading in the fibrous stroma.РB, The tumor cells consist of mucinous columnar cells growing mostly in a lepidic pattern along the surface of alveolar walls. The tumor invades the areas of stromal fibrosis in an acinar pattern. MIA, minimally invasive adenocarcinoma.
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