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定量影像分析预测 COPD 肺癌患者肺叶切除术后的呼吸系统并发症:一项历史性队列研究。

Prediction of Postoperative Respiratory Complications after Lobectomy in Lung Cancer Patients with COPD by Quantitative Image Analysis: A Historical Cohort Study.

机构信息

Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.

Department of Public Health, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2022 Dec 20;28(6):411-419. doi: 10.5761/atcs.oa.22-00133. Epub 2022 Oct 7.

Abstract

PURPOSE

We examined whether preoperative assessment of percentage of low attenuation area (LAA%) on the non-resected side can predict postoperative respiratory complications (PRC) after lobectomy.

MATERIALS AND METHODS

We conducted a historical cohort study of 217 smokers (175 males and 42 females) who underwent lobectomy for primary lung cancer at our hospital between January 2014 and March 2021. First, the relationship between LAA% and respiratory function parameters (RFPs) calculated for both the bilateral and non-resected sides was used to estimate the most effective patient group. Next, multivariate analyses of the relationship between LAA% of the non-resected side and PRC were performed using logistic regression analysis after adjusting for basic patient attributes and respiratory function.

RESULTS

A correlation was found between LAA% and RFP in smoking males. Multivariate analysis showed a strong relationship between model 3, adjusted for basic patient attributes and lung function factors, and PRC (odds ratio, 2.43; 95% confidence interval, 1.05-5.63).

CONCLUSION

LAA% of the non-resected side suggested that it may be able to predict the occurrence of PRC after lung cancer lobectomy.

摘要

目的

我们研究了非切除侧低衰减区(LAA%)百分比的术前评估是否可以预测肺叶切除术后的呼吸并发症(PRC)。

材料和方法

我们对 2014 年 1 月至 2021 年 3 月在我院因原发性肺癌行肺叶切除术的 217 名吸烟者(男性 175 名,女性 42 名)进行了历史队列研究。首先,使用双侧和非切除侧计算的 LAA%与呼吸功能参数(RFPs)之间的关系来估计最有效的患者群体。然后,使用逻辑回归分析对非切除侧 LAA%与 PRC 之间的关系进行多元分析,并调整了基本患者特征和呼吸功能。

结果

在吸烟男性中发现 LAA%与 RFP 之间存在相关性。多变量分析显示,在调整了基本患者特征和肺功能因素的模型 3 中,与 PRC 之间存在很强的关系(优势比,2.43;95%置信区间,1.05-5.63)。

结论

非切除侧的 LAA%可能能够预测肺癌肺叶切除术后 PRC 的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/afdd/9763719/aef1261ef22f/atcs-28-411-g001.jpg

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