Zhang Xiaochuan, Lv Fajin, Fu Binjie, Li Wangjia, Lin Ruiyu, Chu Zhigang
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
Department of Radiology, Chonggang General Hospital, Chongqing, 400080, People's Republic of China.
Cancer Manag Res. 2022 Feb 15;14:589-601. doi: 10.2147/CMAR.S351561. eCollection 2022.
To investigate the clinical and computed tomography (CT) characteristics of peripheral small-cell lung cancer (pSCLC) to improve its early diagnosis.
In total, 70, 132, 69, and 95 patients with pathological confirmed nodular (≤3 cm) pSCLC, peripheral non-small cell lung cancer (pNSCLC), benign lung tumor (pBLT), and inflammatory lesion (pIL) were enrolled in this study retrospectively. The clinical and CT data of studied patients with different lesions were analyzed and compared by univariate analysis. Multivariate analysis was used to reveal the key features to distinguish pSCLC from pNSCLC, pBLT, and pIL, respectively.
Univariate and multivariate analysis of the clinical and CT characteristics of studied patients indicated that 1) compared with pNSCLC and pIL, vessel convergence, spiculation, and peripheral ground-glass opacity were less common in pSCLC; 2) density homogeneity (OR = 38.84-120.21, < 0.05), bronchial cutoff sign (OR = 10.00-60.13, = 0.001), hilar lymph node enlargement (OR = 22.81-95.08, < 0.0001) (pSCLC vs pNSCLC, pBLT, and pIL), male sex (OR = 5.53-10.92, < 0.05) (pSCLC vs pNSCLC and pBLT), and emphysema (OR = 36.57-56.63, < 0.05) (pSCLC vs pBLT and pIL) were significantly and independently associated with pSCLC. Type I and II bronchial cutoff sign, especially type I, were closely related to pSCLC.
Peripheral solid nodules with homogeneous density, bronchial cutoff sign, hilar lymph node enlargement, but without spiculation or vessel convergence in male patients with emphysema should be highly suspected of pSCLC.
探讨周围型小细胞肺癌（pSCLC）的临床及计算机断层扫描（CT）特征，以提高其早期诊断率。
本研究回顾性纳入了70例、132例、69例和95例经病理确诊的结节状（≤3 cm）pSCLC、周围型非小细胞肺癌（pNSCLC）、良性肺肿瘤（pBLT）及炎性病变（pIL）患者。对不同病变患者的临床及CT数据进行单因素分析，并进行比较。采用多因素分析分别揭示区分pSCLC与pNSCLC、pBLT及pIL的关键特征。
对研究患者的临床及CT特征进行单因素和多因素分析表明：1）与pNSCLC和pIL相比，血管集束、毛刺征及周围磨玻璃影在pSCLC中较少见；2）密度均匀性（OR = 38.84 - 120.21，P < 0.05）、支气管截断征（OR = 10.00 - 60.13，P = 0.001）、肺门淋巴结肿大（OR = 22.81 - 95.08，P < 0.0001）（pSCLC与pNSCLC、pBLT及pIL相比）、男性（OR = 5.53 - 10.92，P < 0.05）（pSCLC与pNSCLC和pBLT相比）以及肺气肿（OR = 36.57 - 56.63，P < 0.05）（pSCLC与pBLT和pIL相比）与pSCLC显著且独立相关。Ⅰ型和Ⅱ型支气管截断征，尤其是Ⅰ型，与pSCLC密切相关。
对于有肺气肿的男性患者，出现密度均匀的周围实性结节、支气管截断征、肺门淋巴结肿大，但无毛刺征或血管集束时，应高度怀疑为pSCLC。
