Wang Yan, Pan Zhao-Cheng, Zhu Lan, Ma Yuan-Yuan, Zhang Mu-Chen, Wang Li, Zhao Wei-Li, Yan Fu-Hua, Song Qi
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Quant Imaging Med Surg. 2021 Feb;11(2):772-783. doi: 10.21037/qims-20-1139.
To assess the value of characteristic computed tomography (CT) findings in predicting the survival of patients with pulmonary B-cell non-Hodgkin's lymphoma (NHL).
Eighty-four patients who were histopathologically confirmed with pulmonary B-cell NHL between 2004 and 2018 were retrospectively enrolled. All patients underwent chest CT scan at the time of initial diagnosis in our hospital. Characteristic CT findings and clinicopathological features of the patients were analyzed, and Cox regression models were used to determine the relationship of CT findings with overall survival (OS) and progression-free survival (PFS).
Air bronchogram occurred more frequently in patients with early-stage disease, primary pulmonary lymphoma (PPL) and the indolent histological type of lymphoma than in patients with advanced-stage disease, secondary pulmonary lymphoma (SPL), and the aggressive histological type (all P<0.05). The halo sign was observed most in the SPL group (19/48, 40%; P=0.004), while the presence of cross-lobe sign was higher in patients with PPL (13/36, 36%; P=0.010). Pleural involvement and hilar/mediastinal lymphadenopathy were observed more in patients with SPL and the aggressive histological type (33/48 and 27/48; 31/46 and 26/46, respectively; all P<0.05). Survival analyses showed that the number of lung lesions, cross-lobe sign, and pleural involvement were independent prognostic factors for PFS, while the halo sign and pleural involvement were significantly correlated with OS (all P<0.05). More aggressive, advanced-stage cases and male patients showed worse outcomes.
The halo sign and pleural involvement are independent prognostic factors for OS, while the number of lung lesions, cross-lobe sign, and pleural involvement are correlated with PFS.
评估特征性计算机断层扫描（CT）表现对预测肺B细胞非霍奇金淋巴瘤（NHL）患者生存率的价值。
回顾性纳入2004年至2018年间经组织病理学确诊为肺B细胞NHL的84例患者。所有患者在我院初诊时均接受胸部CT扫描。分析患者的特征性CT表现及临床病理特征，并采用Cox回归模型确定CT表现与总生存期（OS）和无进展生存期（PFS）的关系。
空气支气管征在疾病早期、原发性肺淋巴瘤（PPL）和惰性组织学类型淋巴瘤患者中比在晚期疾病、继发性肺淋巴瘤（SPL）和侵袭性组织学类型患者中更常见（所有P<0.05）。晕征在SPL组中观察到的最多（19/48，40%；P=0.004），而跨叶征在PPL患者中出现的比例更高（13/36，36%；P=0.010）。SPL和侵袭性组织学类型患者中胸膜受累及肺门/纵隔淋巴结肿大更常见（分别为33/48和27/48；31/46和26/46；所有P<0.05）。生存分析表明，肺部病变数量、跨叶征及胸膜受累是PFS的独立预后因素，而晕征和胸膜受累与OS显著相关（所有P<0.05）。更具侵袭性、晚期病例及男性患者预后较差。
晕征和胸膜受累是OS的独立预后因素，而肺部病变数量、跨叶征及胸膜受累与PFS相关。
