Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, 158-0095, Japan.
Lung. 2014 Aug;192(4):583-7. doi: 10.1007/s00408-014-9598-1. Epub 2014 May 16.
Thoracic endometriosis-related pneumothorax (TERP) is a secondary condition specific for females, but in a clinical setting, TERP often is difficult to distinguish from primary spontaneous pneumothorax (PSP) based on a relationship between the dates of pneumothorax and menstruation. The purpose of this study was to clarify the clinical features of TERP compared with PSP.
We retrospectively reviewed the clinical and histopathological files of female patients with pneumothorax who underwent video-assisted thoracoscopic surgery in the Pneumothorax Research Center during the 6-year period from January 2005 to December 2010. We analyzed the clinical differences between TERP and PSP.
The study included a total of 393 female patients with spontaneous pneumothorax, of whom 92 (23.4 %) were diagnosed as having TERP and 33.6 % (132/393) as having PSP. We identified four factors (right-sided pneumothorax, history of pelvic endometriosis, age ≥31 years, and no smoking history) that were statistically significant for predicting TERP and assigned 6, 5, 4, and 3 points, respectively, to establish a scoring system with a calculated score from 0 to 18. The cutoff values of a calculated score ≥12 yielded the highest positive predictive value (86 %; 95 % confidence interval (CI) 81.5-90.5 %) for TERP and negative predictive value (95.2 %; 95 % CI 92.3-98 %) for PSP.
TERP has several distinct clinical features from PSP. Our scoring system consists of only four clinical variables that are easily obtainable and enables us to suspect TERP in female patients with pneumothorax.
胸腔子宫内膜异位症相关气胸（TERP）是一种特定于女性的继发性疾病，但在临床环境中，基于气胸与月经之间的关系，TERP 常难以与原发性自发性气胸（PSP）区分。本研究的目的是阐明 TERP 与 PSP 的临床特征。
我们回顾性分析了 2005 年 1 月至 2010 年 12 月期间气胸研究中心接受电视辅助胸腔镜手术的女性气胸患者的临床和组织病理学资料。我们分析了 TERP 与 PSP 之间的临床差异。
研究共纳入 393 例女性自发性气胸患者，其中 92 例（23.4%）诊断为 TERP，33.6%（132/393）为 PSP。我们确定了四个因素（右侧气胸、盆腔子宫内膜异位症病史、年龄≥31 岁、无吸烟史）对预测 TERP 有统计学意义，分别给予 6、5、4 和 3 分，建立了一个评分系统，计算得分为 0 至 18 分。计算得分≥12 的截断值对 TERP 的阳性预测值（86%；95%置信区间（CI）81.5-90.5%）和 PSP 的阴性预测值（95.2%；95%CI 92.3-98%）最高。
TERP 与 PSP 相比具有一些明显的临床特征。我们的评分系统仅包含四个易于获得的临床变量，可以使我们怀疑患有气胸的女性患者患有 TERP。
