肺硬化性血管平滑肌脂肪瘤与死亡风险。

Pulmonary sclerosing pneumocytoma and mortality risk.

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.

Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea.

出版信息

BMC Pulm Med. 2022 Nov 7;22(1):404. doi: 10.1186/s12890-022-02199-1.

DOI:10.1186/s12890-022-02199-1

PMID:36344955

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9641959/

Abstract

BACKGROUND

Surgical resection is usually recommended for the treatment of pulmonary sclerosing pneumocytoma (PSP). However, no comparative study has demonstrated that surgical resection leads to improved outcomes. We aimed to compare all-cause mortality between patients with PSP who underwent surgery or did not and those without PSP.

METHODS

Participants aged ≥18 years who had pathologically diagnosed PSP between 2001 to 2018, at 3 hospitals were included. Randomly selected (up to 1:5) age-, sex-, and smoking status-matched controls without PSP who were randomly selected from those who underwent health checkups including chest CT were included. Mortality was compared using Kaplan-Meier estimates and Cox proportional hazards regression models. Literature review of studies reporting PSP was also conducted.

RESULTS

This study included 107 patients with PSP (surgery:non-surgery, 80:27) and 520 matched controls. There were no cases of lymph node or distant metastasis, recurrence, or mortality from PSP. No significant difference in all-cause mortality risk was observed between the PSP surgery, PSP non-surgery, and non-PSP groups (log rank test P = 0.78) (PSP surgery vs. non-PSP: adjusted hazards ratio [aHR], 1.80; 95% confidence interval [CI], 0.22-14.6; PSP non-surgery vs. non-PSP: aHR, 0.77; 95% CI, 0.15-3.86; PSP surgery vs. PSP non-surgery: aHR, 2.35; 95% CI, 0.20-28.2). In the literature review, we identified 3469 patients with PSP from 355 studies. Only 1.33% of these patients reported metastasis, recurrence, or death.

CONCLUSIONS

All-cause mortality did not differ between patients with PSP and those without, irrespective of undergoing surgery. Our study and the literature review suggest that PSP has less impact on increased mortality risk.

摘要

背景

手术切除通常被推荐用于治疗肺硬化性血管皮细胞瘤（PSP）。然而，没有比较研究表明手术切除可改善预后。我们旨在比较行手术和未行手术治疗的 PSP 患者与无 PSP 患者之间的全因死亡率。

方法

纳入 2001 年至 2018 年间在 3 家医院经病理诊断为 PSP 的年龄≥18 岁的患者。从接受包括胸部 CT 检查在内的健康检查的人群中随机选择（最多 1:5）年龄、性别和吸烟状况相匹配的无 PSP 的随机对照者。使用 Kaplan-Meier 估计和 Cox 比例风险回归模型比较死亡率。还对报告 PSP 的研究进行了文献综述。

结果

这项研究纳入了 107 例 PSP 患者（手术：非手术，80:27）和 520 例匹配对照者。无 PSP 患者未发生淋巴结或远处转移、复发或 PSP 相关死亡。PSP 手术组、PSP 非手术组和非 PSP 组的全因死亡率风险无显著差异（对数秩检验 P=0.78）（PSP 手术与非 PSP：调整后的危害比[aHR]，1.80；95%置信区间[CI]，0.22-14.6；PSP 非手术与非 PSP：aHR，0.77；95%CI，0.15-3.86；PSP 手术与 PSP 非手术：aHR，2.35；95%CI，0.20-28.2）。在文献综述中，我们从 355 项研究中确定了 3469 例 PSP 患者。这些患者中仅有 1.33%报告了转移、复发或死亡。