Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea; Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 030804, South Korea.
Clin Radiol. 2021 Jan;76(1):76.e37-76.e46. doi: 10.1016/j.crad.2020.08.018. Epub 2020 Sep 16.
To determine if bronchovascular bundle (BVB) thickening on pretreatment computed tomography (CT) images helps predict survival in patients with peripheral small cell lung cancer (pSCLC) ≤3 cm.
The pretreatment CT examinations of 79 histopathologically proven pSCLC ≤3 cm (TNM stage I, 21; II, 13; III, 22; IV, 23) were reviewed retrospectively. The CT characteristics of the nodule and associated findings, including BVB thickening, were evaluated. Progression-free survival (PFS), overall survival (OS), and brain metastasis-free survival were compared with the presence of BVB thickening using Kaplan-Meier and Cox regression analysis.
Among the 79 patients, 34 (43%) had BVB thickening. BVB thickening was prevalent in patients with mediastinal lymph node metastasis (50.9% versus 22.7%; p=0.024) and distant metastasis (60.9% versus 35.7%; p=0.049). Out of the 21 patients with TNM stage IA disease, the 16 patients (76.2%) without BVB thickening showed better PFS, OS, and brain metastasis-free survival (mean, 1,762 versus 483 days; p=0.019: 2,243 versus 1,328 days; p=0.038: 2,274 versus 1,287 days; p=0.038, respectively). Multivariate Cox regression analysis showed that the absence of BVB thickening (hazard ratio [HR], 7.806; 95% CI, 1.241-49.091; p=0.029) and surgery (HR, 0.075; 95% CI, 0.008-0.746; p=0.027) were independent and useful prognostic factors for PFS.
BVB thickening was found more frequently in patients with advanced-stage pSCLC ≤3 cm, and the PFS was more favourable in patients without BVB thickening, with a similar tendency to that of OS and brain metastasis-free survival, in stage IA pSCLC.
确定支气管血管束（BVB）在小细胞肺癌（SCLC）≤3cm 患者的治疗前 CT 图像上的增厚是否有助于预测生存。
回顾性分析了 79 例经组织病理学证实的小细胞肺癌≤3cm（TNM 分期Ⅰ期 21 例，Ⅱ期 13 例，Ⅲ期 22 例，Ⅳ期 23 例）的治疗前 CT 检查。评估了结节的 CT 特征和相关发现，包括 BVB 增厚。使用 Kaplan-Meier 和 Cox 回归分析比较有无 BVB 增厚与无进展生存期（PFS）、总生存期（OS）和脑转移无进展生存期的关系。
79 例患者中，34 例（43%）有 BVB 增厚。BVB 增厚在纵隔淋巴结转移（50.9%比 22.7%；p=0.024）和远处转移（60.9%比 35.7%；p=0.049）患者中更为常见。21 例 TNM ⅠA 期患者中，16 例（76.2%）无 BVB 增厚者 PFS、OS 和脑转移无进展生存期更好（平均分别为 1762 天比 483 天；p=0.019；2243 天比 1328 天；p=0.038；2274 天比 1287 天；p=0.038）。多变量 Cox 回归分析显示，无 BVB 增厚（风险比[HR]，7.806；95%CI，1.241-49.091；p=0.029）和手术（HR，0.075；95%CI，0.008-0.746；p=0.027）是 PFS 的独立且有用的预后因素。
在小细胞肺癌≤3cm 的晚期患者中，BVB 增厚更为常见，在无 BVB 增厚的患者中 PFS 更有利，与 OS 和脑转移无进展生存期的趋势相似，在ⅠA 期 SCLC 中。
