Choi Won Seok, Park Chang Min, Song Yong Sub, Lee Sang Min, Wi Jae Yeon, Goo Jin Mo
Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
Acta Radiol. 2015 Apr;56(4):428-37. doi: 10.1177/0284185114528325. Epub 2014 Mar 10.
For pulmonary subsolid nodules (SSNs) in patients with extrapulmonary malignancies, it is still unclear what proportion of SSNs is transient and how we can more accurately diagnose these transient SSNs.
To investigate the frequency of transient SSNs and their differentiating clinical and thin-section computed tomography (CT) features in patients with extrapulmonary malignancies.
From January 2005 to February 2012, 78 SSNs in 63 individuals (30 men and 33 women; mean age, 55.1 years ± 15.5) with extrapulmonary malignancies were identified. Their clinical and thin-section CT characteristics were reviewed and compared between transient and persistent SSNs. Differentiating factors and their performance were also measured.
Thirty-six of the 78 SSNs (46.2%) were transient. Between transient and persistent SSNs, there were significant differences in patients' age, sex, detection mode, and the presence of eosinophilia, lesion multiplicity, lesion margin, and pleural retraction (P < 0.05). Multivariate analysis revealed that follow-up detected SSNs (adjusted odds ratio [OR], 38.88), multiple lesions (OR, 7.64), and an ill-defined nodular margin (OR, 11.93) were significant discriminators of transient SSNs (P < 0.05). Discrimination of transient SSNs was significantly better upon incorporating both clinical and thin-section CT features than using clinical features alone (P < 0.05).
Approximately half of the SSNs detected in patients with extrapulmonary malignancies were transient. Transient SSNs in these patients can be very accurately differentiated using their thin-section CT and clinical features.
对于肺外恶性肿瘤患者的肺亚实性结节（SSN），目前尚不清楚有多少比例的SSN是一过性的，以及如何更准确地诊断这些一过性SSN。
探讨肺外恶性肿瘤患者一过性SSN的发生率及其在临床和薄层计算机断层扫描（CT）上的鉴别特征。
2005年1月至2012年2月，共纳入63例（30例男性，33例女性；平均年龄55.1岁±15.5岁）肺外恶性肿瘤患者，共发现78个SSN。回顾并比较了一过性和持续性SSN的临床及薄层CT特征。还测量了鉴别因素及其性能。
78个SSN中，36个（46.2%）为一过性。一过性和持续性SSN在患者年龄、性别、发现方式、嗜酸性粒细胞增多、病变数量、病变边缘及胸膜凹陷等方面存在显著差异（P<0.05）。多因素分析显示，随访发现的SSN（校正比值比[OR]，38.88）、多发病变（OR，7.64）及边界不清的结节边缘（OR，11.93）是一过性SSN的显著鉴别因素（P<0.05）。综合临床和薄层CT特征鉴别一过性SSN的效果明显优于单纯使用临床特征（P<0.05）。
肺外恶性肿瘤患者中检测到的SSN约有一半是一过性的。利用薄层CT和临床特征可以非常准确地区分这些患者的一过性SSN。
