Department of Epidemiology, University Medical Center Groningen, University of Groningen, P.O. Box 30 001, FA 40, 9700, RB, Groningen, The Netherlands.
Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Eur Radiol. 2022 Dec;32(12):8162-8170. doi: 10.1007/s00330-022-08884-3. Epub 2022 Jun 9.
This study aimed to evaluate the association between visual emphysema and the presence of lung nodules, and Lung-RADS category with low-dose CT (LDCT).
Baseline LDCT scans of 1162 participants from a lung cancer screening study (Nelcin-B3) performed in a Chinese general population were included. The presence, subtypes, and severity of emphysema (at least trace) were visually assessed by one radiologist. The presence, size, and classification of non-calcified lung nodules (≥ 30 mm) and Lung-RADS category were independently assessed by another two radiologists. Multivariable logistic regression and stratified analyses were performed to estimate the association between emphysema and lung nodules, Lung-RADS category, after adjusting for age, sex, BMI, smoking status, pack-years, and passive smoking.
Emphysema and lung nodules were observed in 674 (58.0%) and 424 (36.5%) participants, respectively. Participants with emphysema had a 71% increased risk of having lung nodules (adjusted odds ratios, aOR: 1.71, 95% CI: 1.26-2.31) and 70% increased risk of positive Lung-RADS category (aOR: 1.70, 95% CI: 1.09-2.66) than those without emphysema. Participants with paraseptal emphysema (n = 47, 4.0%) were at a higher risk for lung nodules than those with centrilobular emphysema (CLE) (aOR: 2.43, 95% CI: 1.32-4.50 and aOR: 1.60, 95% CI: 1.23-2.09, respectively). Only CLE was associated with positive Lung-RADS category (p = 0.02). CLE severity was related to a higher risk of lung nodules (ranges aOR: 1.44-2.61, overall p < 0.01).
In a Chinese general population, visual emphysema based on LDCT is independently related to the presence of lung nodules (≥ 30 mm) and specifically CLE subtype is related to positive Lung-RADS category. The risk of lung nodules increases with CLE severity.
• Participants with emphysema had an increased risk of having lung nodules, especially smokers. • Participants with PSE were at a higher risk for lung nodules than those with CLE, but nodules in participants with CLE had a higher risk of positive Lung-RADS category. • The risk of lung nodules increases with CLE severity.
本研究旨在评估视觉性肺气肿与肺结节存在以及低剂量 CT（LDCT） Lung-RADS 分类之间的关联。
纳入了在中国一般人群中进行的肺癌筛查研究（Nelcin-B3）的 1162 名参与者的基线 LDCT 扫描。由一名放射科医生对肺气肿（至少痕迹）的存在、亚型和严重程度进行视觉评估。另两名放射科医生独立评估非钙化肺结节（≥30mm）的存在、大小和分类以及 Lung-RADS 分类。在调整年龄、性别、BMI、吸烟状况、吸烟年限和被动吸烟后，采用多变量逻辑回归和分层分析来估计肺气肿与肺结节、Lung-RADS 分类之间的关联。
分别在 674 名（58.0%）和 424 名（36.5%）参与者中观察到肺气肿和肺结节。有肺气肿的参与者发生肺结节的风险增加了 71%（调整后的优势比，aOR：1.71，95%CI：1.26-2.31），发生阳性 Lung-RADS 分类的风险增加了 70%（aOR：1.70，95%CI：1.09-2.66）。与中央小叶肺气肿（CLE）相比，间隔旁肺气肿（PSE）（n=47，4.0%）患者发生肺结节的风险更高（aOR：2.43，95%CI：1.32-4.50 和 aOR：1.60，95%CI：1.23-2.09）。仅 CLE 与阳性 Lung-RADS 分类相关（p=0.02）。CLE 严重程度与发生肺结节的风险增加相关（范围 aOR：1.44-2.61，总体 p<0.01）。
在中国一般人群中，基于 LDCT 的视觉性肺气肿与肺结节（≥30mm）的存在独立相关，特别是 CLE 亚型与阳性 Lung-RADS 分类相关。肺结节的风险随 CLE 严重程度增加而增加。
有肺气肿的参与者发生肺结节的风险增加，尤其是吸烟者。
与 CLE 相比，PSE 患者发生肺结节的风险更高，但 CLE 患者的结节发生阳性 Lung-RADS 分类的风险更高。
肺结节的风险随 CLE 严重程度增加而增加。
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