原发性肺癌与结直肠癌患者孤立性肺转移的鉴别：一项回顾性队列研究。
Differentiation of primary lung cancer from solitary lung metastasis in patients with colorectal cancer: a retrospective cohort study.
机构信息
Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-gun, Jeollanam-do, Republic of Korea.
出版信息
World J Surg Oncol. 2021 Jan 24;19(1):28. doi: 10.1186/s12957-021-02131-7.
BACKGROUND
This study aimed to evaluate the computed tomography (CT) features of solitary pulmonary nodule (SPN), which can be a non-invasive diagnostic tool to differentiate between primary lung cancer (LC) and solitary lung metastasis (LM) in patients with colorectal cancer (CRC).
METHODS
This retrospective study included SPNs resected in CRC patients between January 2011 and December 2019. The diagnosis of primary LC or solitary LM was based on histopathologic report by thoracoscopic wedge resection. Chest CT images were assessed by two thoracic radiologists, and CT features were identified by consensus. Predictive parameters for the discrimination of primary LC from solitary LM were evaluated using multivariate logistic regression analysis.
RESULTS
We analyzed CT data of 199 patients (mean age, 65.95 years; 131 men and 68 women). The clinical characteristic of SPNs suggestive of primary LC rather than solitary LM was clinical stages I-II CRC (P < 0.001, odds ratio [OR] 21.70). The CT features of SPNs indicative of primary LC rather than solitary LM were spiculated margin (quantitative) (P = 0.020, OR 8.34), sub-solid density (quantitative) (P < 0.001, OR 115.56), and presence of an air bronchogram (quantitative) (P = 0.032, OR 5.32).
CONCLUSIONS
Quantitative CT features and clinical characteristics of SPNs in patients with CRC could help differentiate between primary LC and solitary LM.
背景
本研究旨在评估孤立性肺结节（SPN）的 CT 特征，这可能是一种非侵入性诊断工具，用于区分结直肠癌（CRC）患者的原发性肺癌（LC）和孤立性肺转移（LM）。
方法
本回顾性研究纳入了 2011 年 1 月至 2019 年 12 月期间经胸腹腔镜楔形切除术切除的 SPN。原发性 LC 或孤立性 LM 的诊断基于组织病理学报告。由两名胸部放射科医生评估胸部 CT 图像，并通过共识确定 CT 特征。使用多变量逻辑回归分析评估鉴别原发性 LC 和孤立性 LM 的预测参数。
结果
我们分析了 199 名患者的 CT 数据（平均年龄 65.95 岁；131 名男性和 68 名女性）。提示 SPN 更倾向于原发性 LC 而不是孤立性 LM 的临床特征是 CRC Ⅰ-Ⅱ期（P < 0.001，优势比 [OR] 21.70）。提示 SPN 更倾向于原发性 LC 而不是孤立性 LM 的 CT 特征是有分叶状边缘（定量）（P = 0.020，OR 8.34）、亚实性密度（定量）（P < 0.001，OR 115.56）和存在空气支气管征（定量）（P = 0.032，OR 5.32）。
结论
CRC 患者 SPN 的定量 CT 特征和临床特征有助于区分原发性 LC 和孤立性 LM。
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