通过薄层 CT 图像评估伴有非典型实性结节的肺腺癌患者的预后。

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Mengwen Liu, Lin Yang, Xujie Sun, Xin Liang, Cong Li, Qianqian Feng, Meng Li, Li Zhang
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The Kaplan-Meier method and multivariable Cox analysis were used to evaluate survival differences among patients with ASNs, SSNs, and TSNs. Results Of the 254 patients (median age, 58 years [IQR, 53-66]; 152 women) evaluated, 49 had ASNs, 123 had SSNs, and 82 had TSNs. Compared with patients with SSNs, those with ASNs were more likely to have nonsmall adenocarcinoma (<i>P</i> < .001), advanced-stage adenocarcinoma (<i>P</i> = .004), nonlepidic growth adenocarcinoma (<i>P</i> < .001), and middle- or low-grade differentiation tumors (<i>P</i> < .001). Compared with patients with TSNs, those with ASNs were more likely to have no lymph node involvement (<i>P</i> = .009) and epidermal growth factor receptor mutation positivity (<i>P</i> = .018). Average disease-free survival in patients with ASNs was significantly longer than that in patients with TSNs (<i>P</i> < .001) but was not distinguishable from that in patients with SSNs (<i>P</i> = .051). 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引用次数: 0

摘要

目的 评价在薄层 CT 图像上显示非典型实性结节(ASN)的临床 IA 期肺腺癌患者的临床病理特征和预后。材料和方法 对 2005 年 1 月至 2012 年 12 月间接受切除术的临床 IA 期肺腺癌患者的数据进行了回顾性研究。根据结节在薄层 CT 图像上的表现,将其分为 ASN、亚实性结节(SSN)和典型实性结节(TSN)。研究了 ASN 的临床病理特征,并分析了三组之间的差异。采用 Kaplan-Meier 法和多变量 Cox 分析法评估 ASN、SSN 和 TSN 患者的生存率差异。结果 在接受评估的 254 名患者(中位年龄 58 岁 [IQR,53-66];152 名女性)中,49 人患有 ASN,123 人患有 SSN,82 人患有 TSN。与 SSN 患者相比,ASN 患者更有可能患有非小腺癌(P < .001)、晚期腺癌(P = .004)、非鳞状生长腺癌(P < .001)以及中低分化肿瘤(P < .001)。与TSN患者相比,ASN患者更可能没有淋巴结受累(P = .009)和表皮生长因子受体突变阳性(P = .018)。ASN患者的平均无病生存期明显长于TSN患者(P < .001),但与SSN患者无明显差异(P = .051)。结论 在临床分期为 IA 期的肺腺癌患者中,ASN 的临床疗效优于 TSN。关键词腺癌 非典型实性结节 CT 无病生存期 肺 预后 肺 本文有补充材料。以 CC BY 4.0 许可发布。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Prognosis in Patients with Lung Adenocarcinoma with Atypical Solid Nodules on Thin-Section CT Images.

Purpose To evaluate the clinicopathologic characteristics and prognosis of patients with clinical stage IA lung adenocarcinoma with atypical solid nodules (ASNs) on thin-section CT images. Materials and Methods Data from patients with clinical stage IA lung adenocarcinoma who underwent resection between January 2005 and December 2012 were retrospectively reviewed. According to their manifestations on thin-section CT images, nodules were classified as ASNs, subsolid nodules (SSNs), and typical solid nodules (TSNs). The clinicopathologic characteristics of the ASNs were investigated, and the differences across the three groups were analyzed. The Kaplan-Meier method and multivariable Cox analysis were used to evaluate survival differences among patients with ASNs, SSNs, and TSNs. Results Of the 254 patients (median age, 58 years [IQR, 53-66]; 152 women) evaluated, 49 had ASNs, 123 had SSNs, and 82 had TSNs. Compared with patients with SSNs, those with ASNs were more likely to have nonsmall adenocarcinoma (P < .001), advanced-stage adenocarcinoma (P = .004), nonlepidic growth adenocarcinoma (P < .001), and middle- or low-grade differentiation tumors (P < .001). Compared with patients with TSNs, those with ASNs were more likely to have no lymph node involvement (P = .009) and epidermal growth factor receptor mutation positivity (P = .018). Average disease-free survival in patients with ASNs was significantly longer than that in patients with TSNs (P < .001) but was not distinguishable from that in patients with SSNs (P = .051). Conclusion ASNs were associated with better clinical outcomes than TSNs in patients with clinical stage IA lung adenocarcinoma. Keywords: Adenocarcinoma, Atypical Solid Nodules, CT, Disease-free Survival, Lung, Prognosis, Pulmonary Supplemental material is available for this article. Published under a CC BY 4.0 license.

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