de Mattos Juliane Nascimento, Santiago Escovar Carlos Eugênio, Zereu Manuela, Rubin Adalberto Sperb, Camargo Spencer Marcantonio, Mohammed Tan-Lucien, Dos Santos Ricardo Sales, Verma Nupur, Penha Pereira Diana, Guedes Pinto Erique, Machuca Tiago, Medeiros Tássia Machado, Hochhegger Bruno
Graduate Program in Pathology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.
Medical Imaging Research Lab, LABIMED, Dept of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
ERJ Open Res. 2022 Jun 20;8(2). doi: 10.1183/23120541.00061-2022. eCollection 2022 Apr.
The aim of this study was to analyse and quantify the prevalence of six comorbidities from lung cancer screening (LCS) on computed tomography (CT) scans of patients from developing countries.
For this retrospective study, low-dose CT scans (n=775) were examined from patients who underwent LCS in a tertiary hospital between 2016 and 2020. An age- and sex-matched control group was obtained for comparison (n=370). Using the software, coronary artery calcification (CAC), the skeletal muscle area, interstitial lung abnormalities, emphysema, osteoporosis and hepatic steatosis were accessed. Clinical characteristics of each participant were identified. A t-test and Chi-squared test were used to examine differences between these values. Interclass correlation coefficients (ICCs) and interobserver agreement (assessed by calculating kappa coefficients) were calculated to assess the correlation of measures interpreted by two observers. p-values <0.05 were considered significant.
One or more comorbidities were identified in 86.6% of the patients and in 40% of the controls. The most prevalent comorbidity was osteoporosis, present in 44.2% of patients and in 24.8% of controls. New diagnoses of cardiovascular disease, emphysema and osteoporosis were made in 25%, 7% and 46% of cases, respectively. The kappa coefficient for CAC was 0.906 (p<0.001). ICCs for measures of liver, spleen and bone density were 0.88, 0.93 and 0.96, respectively (p<0.001).
CT data acquired during LCS led to the identification of previously undiagnosed comorbidities. The LCS is useful to facilitate comorbidity diagnosis in developing countries, providing opportunities for its prevention and treatment.
本研究旨在分析和量化发展中国家患者在计算机断层扫描(CT)肺癌筛查(LCS)中六种合并症的患病率。
在这项回顾性研究中,对2016年至2020年间在一家三级医院接受LCS的患者的低剂量CT扫描(n = 775)进行了检查。获得了年龄和性别匹配的对照组进行比较(n = 370)。使用该软件,获取冠状动脉钙化(CAC)、骨骼肌面积、间质性肺异常、肺气肿、骨质疏松症和肝脂肪变性情况。确定了每位参与者的临床特征。采用t检验和卡方检验来检查这些值之间的差异。计算组内相关系数(ICC)和观察者间一致性(通过计算kappa系数评估),以评估两名观察者解释的测量值之间的相关性。p值<0.05被认为具有统计学意义。
86.6%的患者和40%的对照组中发现了一种或多种合并症。最常见的合并症是骨质疏松症,44.2%的患者和24.8%的对照组中存在该病症。分别有25%、7%和46%的病例被新诊断出患有心血管疾病、肺气肿和骨质疏松症。CAC的kappa系数为0.906(p<0.001)。肝脏、脾脏和骨密度测量的ICC分别为0.88、0.93和0.96(p<0.001)。
LCS期间获取的CT数据有助于发现先前未诊断的合并症。LCS有助于在发展中国家促进合并症的诊断,为其预防和治疗提供机会。