Colombi Davide, Risoli Camilla, Delfanti Rocco, Chiesa Sara, Morelli Nicola, Petrini Marcello, Capelli Patrizio, Franco Cosimo, Michieletti Emanuele
Department of Radiological Functions, Radiology Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, Italy.
Department of Surgery, General Surgery Unit, AUSL Piacenza, Via Taverna 49, 29121 Piacenza, Italy.
Life (Basel). 2023 Jan 10;13(1):198. doi: 10.3390/life13010198.
Background: To test the agreement between postoperative pulmonary function tests 12 months after surgery (mpo-PFTs) for non-small cell lung cancer (NSCLC) and predicted lung function based on the quantification of well-aerated lung (WAL) at staging CT (sCT). Methods: We included patients with NSCLC who underwent lobectomy or segmentectomy without a history of thoracic radiotherapy or chemotherapy treatment with the availability of PFTs at 12 months follow-up. Postoperative predictive (ppo) lung function was calculated using the resected lobe WAL (the lung volume between −950 and −750 HU) at sCT. The Spearman correlation coefficient (rho) and intraclass correlation coefficient (ICC) were used to the test the agreement between WAL ppo-PFTs and mpo-PFTs. Results: the study included 40 patients (68 years-old, IQR 62−74 years-old; 26/40, 65% males). The WAL ppo-forced expiratory volume in 1 s (FEV1) and the ppo-diffusing capacity of the lung for carbon monoxide (%DLCO) were significantly correlated with corresponding mpo-PFTs (rho = 0.842 and 0.717 respectively; p < 0.001). The agreement with the corresponding mpo-PFTs of WAL ppo-FEV1 was excellent (ICC 0.904), while it was good (ICC 0.770) for WAL ppo-%DLCO. Conclusions: WAL ppo-FEV1 and WAL ppo-%DLCO at sCT showed, respectively, excellent and good agreement with corresponding mpo-PFTs measured 12 months after surgery for NSCLC. WAL is an easy parameter obtained by staging CT that can be used to estimate post-resection lung function for patients with borderline pulmonary function undergoing lung surgery.
为了测试非小细胞肺癌（NSCLC）手术后12个月的肺功能测试（mpo - PFTs）与基于分期CT（sCT）上通气良好肺（WAL）定量预测的肺功能之间的一致性。方法：我们纳入了接受肺叶切除术或肺段切除术且无胸部放疗或化疗史、在12个月随访时有肺功能测试结果的NSCLC患者。使用sCT上切除肺叶的WAL（肺容积在−950至−750 HU之间）计算术后预测（ppo）肺功能。采用Spearman相关系数（rho）和组内相关系数（ICC）来测试WAL ppo - PFTs与mpo - PFTs之间的一致性。结果：该研究纳入了40例患者（年龄68岁，四分位间距62 - 74岁；26/40，65%为男性）。WAL ppo - 第1秒用力呼气容积（FEV1）和ppo - 肺一氧化碳弥散量（%DLCO）与相应的mpo - PFTs显著相关（rho分别为0.842和0.717；p < 0.001）。WAL ppo - FEV1与相应的mpo - PFTs一致性极佳（ICC 0.904），而WAL ppo - %DLCO与相应的mpo - PFTs一致性良好（ICC 0.770）。结论：sCT上的WAL ppo - FEV1和WAL ppo - %DLCO分别与NSCLC手术后12个月测量的相应mpo - PFTs表现出极佳和良好的一致性。WAL是通过分期CT获得的一个简单参数，可用于估计肺功能临界的患者接受肺手术后的切除后肺功能。
