Chiang Hung-Hsing, Chang Po-Chih, Chang Ting-Wei, Chen Kai-Hua, Liu Yu-Wei, Li Hsien-Pin, Chou Shah-Hwa, Chang Yu-Tang
Department of Surgery, Division of Chest Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan.
Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan.
J Pers Med. 2023 Mar 9;13(3):497. doi: 10.3390/jpm13030497.
According to recent animal models for lung adenocarcinoma metastasis, cardiac function may be related to the clinical outcome. The aim of this study is to identify a predictable index for postoperative metastasis (POM) that is associated with cardiac function.
Two hundred and seven consecutive patients who underwent thoracoscopic resection for stage I lung adenocarcinoma were included. Disease-free survival (DFS), overall survival (OS), and patients' clinical and pathological characteristics were analyzed.
Among the 207 patients, 17 cases demonstrated metastasis, 110 cases received a preoperative echocardiogram, and six cases had POM. Mitral valve peak A velocity, which is one of the left ventricular diastolic function parameters affected by BMI (MVPABMI), was associated with a negative factor for POM (hazard ratio (HR): 2.139, = 0.019) and a poor 5-year DFS in the above median (100% vs. 87%, = 0.014). The predictable rate increased from 30.7% to 75% when the MVPABMI was above the median = 3.15 in the solid subtype).
MVPABMI is a novel index for POM prediction in early-stage lung adenocarcinoma. This is a pilot study and the first attempt at research to verify that the diastole and the BMI may be associated with POM in early-stage lung adenocarcinoma.
根据最近的肺腺癌转移动物模型，心脏功能可能与临床结局相关。本研究的目的是确定一个与心脏功能相关的术后转移（POM）的可预测指标。
纳入207例连续接受I期肺腺癌胸腔镜切除术的患者。分析无病生存期（DFS）、总生存期（OS）以及患者的临床和病理特征。
在207例患者中，17例发生转移，110例接受了术前超声心动图检查，6例发生POM。二尖瓣A峰速度是受BMI影响的左心室舒张功能参数之一（MVPABMI），与POM的负性因素相关（风险比（HR）：2.139，P = 0.019），且在上述中位数以上时5年DFS较差（100%对87%，P = 0.014）。在实性亚型中，当MVPABMI高于中位数3.15时，预测率从30.7%提高到75%。
MVPABMI是早期肺腺癌POM预测的新指标。这是一项初步研究，也是首次尝试验证舒张功能和BMI可能与早期肺腺癌的POM相关联的研究。
