Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
Department of Radiology, Chonggang General Hospital, Chongqing, PR China.
Acta Radiol. 2023 Sep;64(9):2526-2534. doi: 10.1177/02841851231188060. Epub 2023 Jul 18.
Some peripheral small cell lung cancers (pSCLCs) and benign lung tumors (pBLTs) have similar morphological features but different treatment and prognosis.
To determine the significance of marginal vessels in differentiating pSCLCs and pBLTs.
A total of 57 and 95 patients with pathological confirmed nodular (≤3 cm) pSCLC and pBLT with similar morphological features were enrolled in this study retrospectively. The patients' clinical characteristics and computed tomography (CT) features of tumors and marginal vessels (vessels connecting with tumors) were analyzed and compared.
Compared with pBLTs, pSCLCs had a larger diameter ( = 0.001) but lower enhancement ( = 0.015) and fewer had calcification ( = 0.013). Compared with pBLTs, more lesions had proximal (70.2% vs. 22.1%) and distal (59.6% vs. 4.2%) marginal vessels in pSCLCs (each < 0.0001). In addition, in pSCLCs, the numbers of proximal (1.3 ± 1.4 vs. 0.3 ± 0.6), distal (2.4 ± 3.1 vs. 0.1 ± 0.5), and total (3.6 ± 3.5 vs. 0.4 ± 1.0) marginal vessels were all more than those in pBLTs (each < 0.001). Receiver operating characteristic curve analysis revealed the positive distal marginal vessel sign had the highest specificity (95.8%), and the number of total marginal vessels had the best performance in discriminating pSCLC from pBLT (cutoff value = 1.5, AUC = 0.80, 95% CI = 0.72-0.89, sensitivity = 70.2%, and specificity = 91.6%).
For peripheral solid nodules similar to pBLTs but without any calcification, the possibility of pSCLC should be considered if they have multiple marginal vessels (≥2), especially the distal ones.
一些周围型小细胞肺癌（pSCLC）和良性肺肿瘤（pBLT）具有相似的形态学特征，但治疗和预后不同。
确定边缘血管在鉴别 pSCLC 和 pBLT 中的意义。
回顾性分析了 57 例和 95 例经病理证实的结节性（≤3cm）pSCLC 和具有相似形态学特征的 pBLT 患者的临床特征以及肿瘤和边缘血管（与肿瘤相连的血管）的 CT 特征。
与 pBLT 相比，pSCLC 的直径更大（=0.001），但增强程度更低（=0.015），钙化更少（=0.013）。与 pBLT 相比，更多的病变在 pSCLC 中有近端（70.2%比 22.1%）和远端（59.6%比 4.2%）边缘血管（均<0.0001）。此外，在 pSCLC 中，近端（1.3±1.4 比 0.3±0.6）、远端（2.4±3.1 比 0.1±0.5）和总数（3.6±3.5 比 0.4±1.0）的边缘血管数量均多于 pBLT（均<0.001）。受试者工作特征曲线分析显示，阳性远端边缘血管征具有最高的特异性（95.8%），而总边缘血管数在鉴别 pSCLC 和 pBLT 方面表现最佳（截断值=1.5，AUC=0.80，95%CI=0.72-0.89，敏感性=70.2%，特异性=91.6%）。
对于与 pBLT 相似但无任何钙化的周围实性结节，如果存在多个边缘血管（≥2），尤其是远端边缘血管，则应考虑 pSCLC 的可能性。
