CT 上胸膜尾征与不紧贴胸膜的周围型肺癌脏层胸膜侵犯的相关性。
Correlation between pleural tags on CT and visceral pleural invasion of peripheral lung cancer that does not appear touching the pleural surface.
机构信息
Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, 755-8505, Japan.
Department of Pathology, National Hospital Organization Kanmon Medical Center, Shimonoseki, Japan.
出版信息
Eur Radiol. 2021 Dec;31(12):9022-9029. doi: 10.1007/s00330-021-07869-y. Epub 2021 May 21.
OBJECTIVES
To evaluate the association between a sign and visceral pleural invasion (VPI) of peripheral non-small-cell lung cancer (NSCLC) that does not appear touching the pleural surface.
METHODS
A total of 221 consecutive patients with NSCLC that did not appear touching the pleural surface, ≤ 3 cm in solid tumor diameter, and was surgically resected between January 2009 and December 2015 were included. We focused on the flat distortion of the tumor caused by an arch-shaped linear tag between the tumor and the pleura on CT and named it a bridge tag sign. We evaluated the associations between the clinicopathological features of the tumor, including the bridge tag sign, and VPI. We also evaluated the associations between histopathological findings and the bridge tag sign. The utility of the bridge tag sign in the diagnosis of VPI was statistically assessed.
RESULTS
The bridge tag sign was observed in 48 (20.8%) patients. VPI was positive in 9 (4.1%) patients; among these, the bridge tag sign was positive in 8 patients. In multivariate analysis, a bridge tag sign was significantly associated with VPI. The bridge tag sign was associated with longer contact length of the pleura with the tumor and trapezoid type pleural retraction. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the bridge tag sign in the diagnosis of VPI were 88.9%, 83.5%, 83.7%, 18.6%, and 99.4%, respectively.
CONCLUSIONS
A bridge tag sign on CT might improve the accuracy of the prediction of VPI.
KEY POINTS
• We present the bridge tag sign which is defined as a flat distortion of an NSCLC tumor by an arch-shaped linear tag between the tumor and chest wall or interlobar fissure. • The bridge tag sign was an independent predictive factor for visceral pleural invasion. • The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the bridge tag sign in the diagnosis of visceral pleural invasion were 88.9%, 83.5%, 83.7%, 18.6%, and 99.4%, respectively.
目的
评估非小细胞肺癌（NSCLC）的胸膜侵犯（VPI）与不接触胸膜表面的周围型 NSCLC 之间的关系。
方法
纳入 2009 年 1 月至 2015 年 12 月期间手术切除的 221 例不接触胸膜表面、实体肿瘤直径≤3cm 的连续 NSCLC 患者。我们关注的是 CT 上肿瘤与胸膜之间的弓形线性标记导致的肿瘤平面变形，并将其命名为桥接标签征。我们评估了肿瘤的临床病理特征，包括桥接标签征与 VPI 之间的关系。我们还评估了组织病理学发现与桥接标签征之间的关系。统计学评估了桥接标签征在 VPI 诊断中的应用价值。
结果
48 例（20.8%）患者出现桥接标签征。9 例（4.1%）患者 VPI 阳性；其中 8 例桥接标签征阳性。多变量分析显示，桥接标签征与 VPI 显著相关。桥接标签征与胸膜与肿瘤的接触长度较长和梯形胸膜回缩有关。桥接标签征在 VPI 诊断中的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为 88.9%、83.5%、83.7%、18.6%和 99.4%。
结论
CT 上的桥接标签征可能提高 VPI 预测的准确性。
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