Department of Anesthesiology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China.
Department of Radiology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, China.
Medicine (Baltimore). 2023 Jul 21;102(29):e34201. doi: 10.1097/MD.0000000000034201.
The objective was to explore the relationships between computed tomography (CT) lung volume parameters and pulmonary function test (PFT) indexes and develop predictive scores to predict PFT indexes in Chinese preoperative patients suspected with lung cancer. Preoperative patients suspected with lung cancer aged 18 years or more and examined by chest CT scan and PET were consecutively recruited from April to August 2020, at Yunnan Cancer Hospital. CT and PET data were selected from medical record. Pearson correlation was used to explore the relationships between CT parameters and PFT indexes. Predictive scores of PFT indexes were developed from unstandardized coefficients of linear regression models of using CT parameters as predictors. The assessments of predictive ability of scores were conducted by receiver operating characteristics curves. A total of 124 preoperative patients suspected with lung cancer participated in this study. Total lung volume significantly correlated with total lung capacity (r = 0.708), residual volume (r = 0.411), forced expiratory volume in one second (FEV1, r = 0.535), forced vital capacity (FVC, r = 0.687), and FEV1/FVC (r = -0.319). Percent of low attenuation volume significantly correlated with total lung capacity (r = 0.200), residual volume (r = 0.215), FEV1 percentage of predictive value (FEV1%, r = -0.204) and FEV1/FVC (r = -0.345). Four predictive scores for FEV1, FEV1%, FEV1/FVC and FVC% were developed. The area under the curve of receiver operating characteristics for FEV1 <2L, FEV1% <80%, FEV1/FVC <80% and FVC% <80% were 0.856, 0.667, 0.749 and 0.715, respectively. A prediction of poor lung function in preoperative patients suspected with lung cancer, using total lung volume and percent of low attenuation volume was possible. The predictive scores should be further evaluated for external validity.
目的在于探索计算机断层扫描(CT)肺容积参数与肺功能测试(PFT)指标之间的关系,并建立预测评分以预测中国术前疑似肺癌患者的 PFT 指标。2020 年 4 月至 8 月,连续招募了年龄在 18 岁及以上、接受胸部 CT 扫描和 PET 检查的云南肿瘤医院术前疑似肺癌患者。从病历中选择 CT 和 PET 数据。采用 Pearson 相关分析探讨 CT 参数与 PFT 指标之间的关系。采用 CT 参数作为预测因子的线性回归模型的未标准化系数,建立 PFT 指标的预测评分。通过受试者工作特征曲线评估评分的预测能力。共 124 例术前疑似肺癌患者参与本研究。全肺容积与肺活量(r = 0.708)、残气量(r = 0.411)、一秒用力呼气容积(FEV1,r = 0.535)、用力肺活量(FVC,r = 0.687)和 FEV1/FVC(r = -0.319)呈显著相关。低衰减容积百分比与全肺容积(r = 0.200)、残气量(r = 0.215)、FEV1 预计值百分比(FEV1%,r = -0.204)和 FEV1/FVC(r = -0.345)呈显著相关。建立了 FEV1、FEV1%、FEV1/FVC 和 FVC%的 4 个预测评分。受试者工作特征曲线下面积(AUC)对于 FEV1<2L、FEV1%<80%、FEV1/FVC<80%和 FVC%<80%的预测分别为 0.856、0.667、0.749 和 0.715。可以对术前疑似肺癌患者的肺功能进行预测。预测评分的外部有效性尚需进一步评估。