Hayashi Hideyuki, Ashizawa Kazuto, Ogihara Yukihiro, Nishida Akifumi, Matsumoto Keitaro, Yamasaki Naoya, Nagayasu Takeshi, Fukuda Minoru, Honda Sumihisa, Uetani Masataka
Unit of Translational Medicine, Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Department of Radiology, Nagasaki Prefectural Shimabara Hospital, Nagasaki, Japan.
Jpn J Radiol. 2017 Mar;35(3):109-115. doi: 10.1007/s11604-017-0610-6. Epub 2017 Jan 21.
To correlate the tumor size and solid component size on thin-section CT (TS-CT) with pathological findings including lymph node (LN) metastasis and local invasion in T1 lung adenocarcinoma.
188 patients with surgically resected T1 lung adenocarcinoma were retrospectively analyzed. Two chest radiologists measured the long-axis and short-axis dimensions of nodules and solid components with a lung and/or a mediastinal window setting (WS) on TS-CT. After analyzing interobserver agreement, average long-axis dimensions of the measured tumors and solid components were correlated with pathological findings.
Seven of 188 patients (3.7%) had pathologic LN-positive metastasis. In patients in whom the long axis of the solid component was <5 mm with a mediastinal WS or <8 mm with a lung WS on TS-CT, no LN metastases were observed, resulting in a positive predictive value (PPV) for predicting a pathologic LN-negative status of 100% with each WS. Based on the same diagnostic criteria, the PPVs for a pathological local invasion (LI)-negative status were 91 (40/44) and 90% (55/61), respectively.
Solid component size on TS-CT may have the potential to predict LN-negative or LI-negative status.
将薄层CT（TS-CT）上的肿瘤大小和实性成分大小与包括T1期肺腺癌的淋巴结（LN）转移和局部侵犯在内的病理结果相关联。
对188例接受手术切除的T1期肺腺癌患者进行回顾性分析。两名胸部放射科医生在TS-CT上使用肺窗和/或纵隔窗设置（WS）测量结节和实性成分的长轴和短轴尺寸。在分析观察者间一致性后，将测量的肿瘤和实性成分的平均长轴尺寸与病理结果相关联。
188例患者中有7例（3.7%）有病理LN阳性转移。在TS-CT上实性成分长轴在纵隔窗下<5 mm或在肺窗下<8 mm的患者中，未观察到LN转移，每种窗设置预测病理LN阴性状态的阳性预测值（PPV）均为100%。基于相同的诊断标准，病理局部侵犯（LI）阴性状态的PPV分别为91%（40/44）和90%（55/61）。
TS-CT上的实性成分大小可能有预测LN阴性或LI阴性状态的潜力。
