肿瘤实性部分大小和实性部分体积在临床I期非小细胞肺癌患者中的预后价值。
Prognostic value of tumor solid-part size and solid-part volume in patients with clinical stage I non-small cell lung cancer.
作者信息
Shimada Yoshihisa, Furumoto Hideyuki, Imai Kentaro, Masuno Ryuhei, Matsubayashi Jun, Kajiwara Naohiro, Ohira Tatsuo, Ikeda Norihiko
机构信息
Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan.
Department of Radiology, Tokyo Medical University, Tokyo, Japan.
出版信息
J Thorac Dis. 2018 Dec;10(12):6491-6500. doi: 10.21037/jtd.2018.11.08.
BACKGROUND
This study aimed to predict the malignant potential of clinical stage I non-small cell lung cancer (c-I NSCLC) by semiautomatic three-dimensional (3D) volumetric measurement of a tumor (3D-data) and the axial computed tomography (CT) data derived from a 3D volumetric dataset (2D-data). The predictive performance was evaluated in terms of overall survival (OS), disease-free survival (DFS), and pathological invasive factors (positive lymphatic invasion, blood vessel invasion, pleural invasion, or lymph node metastasis).
METHODS
We identified 252 patients (122 male; mean age, 68 years; range, 23-84 years) with c-I NSCLC who underwent high resolution CT and reconstruction of 3D imaging, followed by complete resection between January 2012 and December 2015. In this study, 2D-data including whole tumor size (WTS) and solid-part size (SPS) and 3D-data including whole tumor volume (WTV) and solid-part volume (SPV) acquired by a 3D volume rendering software were analyzed.
RESULTS
The area under the receiver operating characteristic (ROC) curve for WTS, SPS, WTV, SPV relevant to recurrence was 0.667, 0.727, 0.654, and 0.751 while analyses of ROC curves revealed optimal WTS, SPS, WTV, and SPV cut-off values to predict recurrence of 2.48 cm, 2.03 cm, 3,258 mm and 1,889 mm, respectively. The association between SPS and SPV was the coefficient of determination ( ) =0.59. Multivariate analysis showed that SPV >1,889 mm (P=0.016) and male (P=0.041) were significant predictors of OS whereas SPV >1,889 mm (P=0.001), male (P=0.003), and the serum carcinoembryonic antigen value (P=0.041) were significantly correlated with DFS. SPS, SPV as well as the combination of SPS and SPV were all significantly correlated with the prediction of OS and DFS, and the incidence of pathological invasive factors.
CONCLUSIONS
SPV and the integrated use of SPS and SPV was highly beneficial for the prediction of postoperative prognosis in c-I NSCLC.
背景
本研究旨在通过对肿瘤进行半自动三维（3D）体积测量（3D数据）以及从3D体积数据集中获取的轴向计算机断层扫描（CT）数据（2D数据）来预测临床I期非小细胞肺癌（c-I NSCLC）的恶性潜能。根据总生存期（OS）、无病生存期（DFS）和病理侵袭因素（阳性淋巴管侵袭、血管侵袭、胸膜侵袭或淋巴结转移）评估预测性能。
方法
我们纳入了252例c-I NSCLC患者（男性122例；平均年龄68岁；范围23 - 84岁），这些患者在2012年1月至2015年12月期间接受了高分辨率CT及3D成像重建，随后进行了根治性手术。在本研究中，分析了通过3D容积再现软件获取的包括肿瘤整体大小（WTS）和实性部分大小（SPS）的2D数据以及包括肿瘤整体体积（WTV）和实性部分体积（SPV）的3D数据。
结果
与复发相关的WTS、SPS、WTV、SPV的受试者工作特征（ROC）曲线下面积分别为0.667、0.727、0.654和0.751，而ROC曲线分析显示预测复发的最佳WTS、SPS、WTV和SPV截断值分别为2.48 cm、2.03 cm、3258 mm和1889 mm。SPS与SPV之间的关联是决定系数（ ）=0.59。多因素分析显示，SPV>1889 mm（P = 0.016）和男性（P = 0.041）是OS的显著预测因素，而SPV>1889 mm（P = 0.001）、男性（P = 0.003）和血清癌胚抗原值（P = 0.041）与DFS显著相关。SPS、SPV以及SPS与SPV的组合均与OS、DFS的预测以及病理侵袭因素的发生率显著相关。
结论
SPV以及SPS和SPV的综合应用对预测c-I NSCLC的术后预后非常有益。
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