Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China.
Eur J Radiol. 2021 Jul;140:109746. doi: 10.1016/j.ejrad.2021.109746. Epub 2021 Apr 30.
To evaluate computed tomography (CT) features and establish a predictive model for the clinical diagnosis and prognosis of tracheal adenoid cystic carcinoma (ACC).
From January 2010 to December 2018, 82 patients with tracheal tumors, including 46 patients with ACC confirmed by surgery and histopathology, were enrolled in this study. These patients' clinicopathologic information, CT features and survival outcomes were recorded and analyzed. Independent predictors of diagnosis and prognosis of tracheal ACC were determined by both univariate and multivariate analyses.
Compared with tracheal non-ACC patients, univariate analysis showed that ACC patients were more likely to have extensive longitudinal length (p < 0.001) and to appear as annular wall thickening (p = 0.001), transmural growth (p = 0.036), poorly defined border (p = 0.003) and mild enhancement (p = 0.001). Multivariate logistic analysis showed that longitudinal length and enhancement degree were independent predictors of tracheal ACC. The 3-year and 5-year disease-free survival (DFS) were 75.7 % and 64.5 %, respectively. Longitudinal length (≥ 34 mm), transverse length (≥ 20 mm) and transmural growth were associated with poor DFS in univariate analysis. After multivariate adjustment, only transverse length (≥ 20 mm) was an adverse prognostic factor for DFS (hazard ratio = 4.594, 95 % confidence interval = 1.240-17.017; p = 0.022).
CT longitudinal length and enhancement degree of tumors showed satisfactory discrimination for tracheal ACC. Excessive CT transverse length might be an unfavorable indicator for ACC recurrence and could be helpful for predicting the survival outcomes of ACC at the initial diagnosis.
评估计算机断层扫描（CT）特征，建立预测气管腺样囊性癌（ACC）临床诊断和预后的模型。
回顾性分析 2010 年 1 月至 2018 年 12 月期间 82 例经手术和组织病理学证实的气管肿瘤患者的临床病理资料、CT 特征和生存结果。记录并分析患者的临床病理资料、CT 特征和生存结果。采用单因素和多因素分析确定气管 ACC 的诊断和预后的独立预测因素。
与气管非 ACC 患者相比，单因素分析显示，ACC 患者更有可能具有广泛的纵向长度（p<0.001）和环形壁增厚（p=0.001）、壁内生长（p=0.036）、边界不清（p=0.003）和轻度强化（p=0.001）。多因素 logistic 分析显示，纵向长度和强化程度是气管 ACC 的独立预测因素。3 年和 5 年无病生存率（DFS）分别为 75.7%和 64.5%。纵向长度（≥34mm）、横向长度（≥20mm）和壁内生长与单因素分析中的 DFS 不良相关。多因素调整后，只有横向长度（≥20mm）是 DFS 的不良预后因素（风险比=4.594，95%置信区间=1.240-17.017；p=0.022）。
肿瘤 CT 纵向长度和强化程度对气管 ACC 具有较好的鉴别能力。CT 横径过大可能是 ACC 复发的不利指标，有助于预测 ACC 初始诊断时的生存结果。
