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头颈部鳞状细胞癌患者的既往间质性肺异常及其治疗后的随访

Pre-Existing Interstitial Lung Abnormalities in Patients with Head and Neck Squamous Cell Carcinoma and Their Follow Up after Therapy.

作者信息

Vuković Danica, Budimir Mršić Danijela, Jerković Kristian, Benzon Benjamin, Tadić Tade

机构信息

Clinical Department of Diagnostic and Interventional Radiology, University Hospital Split, Šoltanska 2, 21000 Split, Croatia.

School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia.

出版信息

Diagnostics (Basel). 2023 Sep 11;13(18):2908. doi: 10.3390/diagnostics13182908.

Abstract

Interstitial lung abnormalities (ILAs) are incidentally found nondependent parenchymal abnormalities affecting more than 5% of any lung zone and are potentially related to interstitial lung disease and worsening post-treatment outcomes in malignancies and infectious diseases. The aim of this study was to determine the prevalence and type of ILA changes in patients with head and neck squamous cell carcinoma (HNSCC) and their change in the follow-up period. This retrospective single-center study included 113 patients with newly diagnosed HNSCC who underwent lung MSCT prior to treatment. ILAs were reported in 13.3% of patients on pretreatment MSCT. Patients with ILAs were significantly older (median 75 vs. 67 years). ILAs were most prevalent in lower zones (73.3%) ( = 0.0045). The most reported ILA subtype was subpleural non-fibrotic (60%) ( = 0.0354). Reticulations were the most frequently described pattern (93.3%) ( < 0.0001). Progression of ILAs was reported in almost 30% of patients after receiving therapy. Patients with pre-existing ILAs were more likely to develop radiation-induced lung fibrosis after adjuvant radiotherapy ( = 0.0464). In conclusion, ILA's incidence, distribution and presentation were similar to previous research conducted in other special cohorts. Our research suggests a possible association of more frequent radiation pneumonitis with ILA changes in patients with HNSCC, which should be further investigated.

摘要

间质性肺异常(ILA)是偶然发现的非下垂部位的实质异常,累及任何肺区的比例超过5%,可能与间质性肺疾病以及恶性肿瘤和传染病治疗后预后恶化有关。本研究的目的是确定头颈部鳞状细胞癌(HNSCC)患者ILA变化的患病率和类型及其在随访期间的变化。这项回顾性单中心研究纳入了113例新诊断的HNSCC患者,这些患者在治疗前接受了肺部MSCT检查。治疗前MSCT检查发现13.3%的患者存在ILA。有ILA的患者年龄显著更大(中位年龄75岁对67岁)。ILA在肺下区最为常见(73.3%)(P = 0.0045)。最常报告的ILA亚型是胸膜下非纤维化型(60%)(P = 0.0354)。网状影是最常描述的影像表现(93.3%)(P < 0.0001)。近30%的患者在接受治疗后ILA出现进展。既往有ILA的患者在辅助放疗后更易发生放射性肺纤维化(P = 0.0464)。总之,ILA的发生率、分布和表现与先前在其他特殊队列中进行的研究相似。我们的研究表明,HNSCC患者中更频繁的放射性肺炎可能与ILA变化有关,这一点应进一步研究。

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