Tailor Tina D, Schmidt Rodney A, Eaton Keith D, Wood Douglas E, Pipavath Sudhakar N J
Departments of *Radiology †Pathology ‡Medicine, Division of Oncology §Department of Surgery, University of Washington Medical Center, Seattle, WA.
J Thorac Imaging. 2015 Sep;30(5):308-13. doi: 10.1097/RTI.0000000000000168.
Our purpose was to evaluate whether pseudocavitation, characterized by round or oval areas of low attenuation in a lesion on computed tomography (CT), can help distinguish adenocarcinoma from other types of non-small cell lung cancer (NSCLC). We also sought to determine whether pseudocavitation is associated with lepidic growth on histopathology.
This retrospective HIPAA-compliant study was approved by our institutional review board. The need for informed consent was waived. CT scans and pathology records from 158 NSCLCs in 149 patients were retrospectively reviewed. The frequency of pseudocavitation was compared among types of NSCLC, specifically adenocarcinoma versus other types of NSCLC. Subgroup analysis of adenocarcinomas was performed to identify any difference in the frequency of pseudocavitation between adenocarcinomas with reported lepidic growth and those without lepidic growth.
There was a significantly greater frequency of pseudocavitation in adenocarcinomas versus other types of NSCLC [19/86 (22.1%) vs. 4/72 (5.6%), P=0.007]. The sensitivity and specificity of the pseudocavitation sign for adenocarcinoma were 0.22 and 0.94, respectively. Among adenocarcinomas, the pseudocavitation sign was more frequent in tumors with lepidic growth versus those without lepidic growth [10/24 (41.7%) vs. 9/62 (14.5%), P=0.015].
Pseudocavitation at CT is more common in primary lung adenocarcinoma than in other types of NSCLC. It is also more common in adenocarcinomas with lepidic growth, suggesting a correlation between the imaging finding of pseudocavitation and the pathologic finding of lepidic growth. As the subtype of NSCLC guides treatment, predicting tumor pathology by imaging may improve diagnostic workup for patients with NSCLC.
我们的目的是评估在计算机断层扫描（CT）上表现为病变内圆形或椭圆形低衰减区域的假空洞，是否有助于将腺癌与其他类型的非小细胞肺癌（NSCLC）区分开来。我们还试图确定假空洞是否与组织病理学上的鳞屑样生长相关。
这项符合健康保险流通与责任法案（HIPAA）的回顾性研究获得了我们机构审查委员会的批准。无需知情同意。对149例患者的158例NSCLC的CT扫描和病理记录进行了回顾性分析。比较了不同类型NSCLC中假空洞的发生率，特别是腺癌与其他类型NSCLC。对腺癌进行亚组分析，以确定有鳞屑样生长报告的腺癌与无鳞屑样生长的腺癌在假空洞发生率上是否存在差异。
腺癌中的假空洞发生率显著高于其他类型的NSCLC [19/86（22.1%）对4/72（5.6%），P = 0.007]。假空洞征对腺癌的敏感性和特异性分别为0.22和0.94。在腺癌中，有鳞屑样生长的肿瘤比无鳞屑样生长的肿瘤假空洞征更常见 [10/24（41.7%）对9/62（14.5%），P = 0.015]。
CT上的假空洞在原发性肺腺癌中比在其他类型的NSCLC中更常见。在有鳞屑样生长的腺癌中也更常见，这表明假空洞的影像学表现与鳞屑样生长的病理表现之间存在相关性。由于NSCLC的亚型指导治疗，通过影像学预测肿瘤病理可能会改善NSCLC患者的诊断检查。
