Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Cancer Imaging. 2021 Jan 19;21(1):14. doi: 10.1186/s40644-021-00383-w.
Interstitial lung abnormalities (ILA) can be detected on computed tomography (CT) in lung cancer patients and have an association with mortality in advanced non-small cell lung cancer (NSCLC) patients. The aim of this study is to demonstrate the significance of ILA for mortality in patients with stage I NSCLC using Boston Lung Cancer Study cohort.
Two hundred and thirty-one patients with stage I NSCLC from 2000 to 2011 were investigated in this retrospective study (median age, 69 years; 93 males, 138 females). ILA was scored on baseline CT scans prior to treatment using a 3-point scale (0 = no evidence of ILA, 1 = equivocal for ILA, 2 = ILA) by a sequential reading method. ILA score 2 was considered the presence of ILA. The difference of overall survival (OS) for patients with different ILA scores were tested via log-rank test and multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) including ILA score, age, sex, smoking status, and treatment as the confounding variables.
ILA was present in 22 out of 231 patients (9.5%) with stage I NSCLC. The presence of ILA was associated with shorter OS (patients with ILA score 2, median 3.85 years [95% confidence interval (CI): 3.36 - not reached (NR)]; patients with ILA score 0 or 1, median 10.16 years [95%CI: 8.65 - NR]; P < 0.0001). In a Cox proportional hazards model, the presence of ILA remained significant for increased risk for death (HR = 2.88, P = 0.005) after adjusting for age, sex, smoking and treatment.
ILA was detected on CT in 9.5% of patients with stage I NSCLC. The presence of ILA was significantly associated with a shorter OS and could be an imaging marker of shorter survival in stage I NSCLC.
在肺癌患者的计算机断层扫描（CT）上可以检测到间质肺异常（ILA），并且与晚期非小细胞肺癌（NSCLC）患者的死亡率相关。本研究的目的是使用波士顿肺癌研究队列，证明 ILA 对 I 期 NSCLC 患者死亡率的意义。
本回顾性研究共纳入 2000 年至 2011 年间 231 例 I 期 NSCLC 患者（中位年龄 69 岁；男性 93 例，女性 138 例）。采用序贯阅读法，在基线 CT 扫描上用 3 分制（0=无 ILA 证据，1=ILA 可疑，2=ILA）对 ILA 进行评分。ILA 评分 2 被认为存在 ILA。通过对数秩检验检验不同 ILA 评分患者的总生存（OS）差异，并使用多变量 Cox 比例风险模型估计危险比（HR），包括 ILA 评分、年龄、性别、吸烟状况和治疗作为混杂因素。
231 例 I 期 NSCLC 患者中，22 例（9.5%）存在 ILA。ILA 的存在与较短的 OS 相关（ILA 评分 2 的患者，中位 OS 3.85 年[95%CI：3.36-NR]；ILA 评分 0 或 1 的患者，中位 OS 10.16 年[95%CI：8.65-NR]；P<0.0001）。在 Cox 比例风险模型中，在调整年龄、性别、吸烟和治疗后，ILA 的存在对死亡风险增加仍有显著意义（HR=2.88，P=0.005）。
在 9.5%的 I 期 NSCLC 患者的 CT 上可以检测到 ILA。ILA 的存在与较短的 OS 显著相关，可能是 I 期 NSCLC 患者生存时间较短的影像学标志物。
