Ni Lei, Wang Qihui, Wang Yilong, Du Yaqi, Sun Zhenggang, Fan Guoguang, Li Ce, Wang Guan
Department of Radiology, The First Hospital of China Medical University, No.155, North Nanjing Street, Shenyang, 110001, Liaoning, China.
Department of Clinical Laboratory, The First Hospital of China Medical University, Shenyang, China.
Cancer Imaging. 2024 Jul 16;24(1):94. doi: 10.1186/s40644-024-00739-y.
To explore the pulmonary-vascular-stump filling-defect on CT and investigate its association with cancer progression.
Records in our institutional database from 2018 to 2022 were retrospectively analyzed to identify filling-defects in the pulmonary-vascular-stump after lung cancer resection and collect imaging and clinical data of patients.
Among the 1714 patients analyzed, 95 cases of filling-defects in the vascular stump after lung cancer resection were identified. After excluding lost-to-follow-up cases, a total of 77 cases were included in the final study. Morphologically, the filling-defects were dichotomized as 46 convex-shape and 31 concave-shape cases. Concave defects exhibited a higher incidence of increase compared to convex defects (51.7% v. 9.4%, P = 0.001). Among 61 filling defects in the pulmonary arterial stump, four (6.5%) increasing concave defects showed the nuclide concentration on PET and extravascular extension. The progression-free survival (PFS) time differed significantly among the concave, convex, and non-filling-defect groups (log-rank P < 0.0001), with concave defects having the shortest survival time. Multivariate Cox proportional hazards analysis indicated that the shape of filling-defects independently predicted PFS in early onset on CT (HR: 0.46; 95% CI: 0.39-1.99; P = 0.04). In follow-ups, the growth of filling-effects was an independent predictor of PFS (HR: 0.26; 95% CI: 0.11-0.65; P = 0.004).
Certain filling-defects in the pulmonary-arterial-stump post lung tumor resection exhibit malignant growth. In the early onset of filling-defects on CT, the concave-shape independently predicted cancer-progression, while during the subsequent follow-up, the growth of filling-defects could be used independently to forecast cancer-progression.
探讨CT上肺血管残端充盈缺损情况，并研究其与癌症进展的关系。
回顾性分析我院2018年至2022年机构数据库中的记录，以确定肺癌切除术后肺血管残端的充盈缺损情况，并收集患者的影像学和临床资料。
在分析的1714例患者中，发现95例肺癌切除术后血管残端充盈缺损。排除失访病例后，最终纳入77例进行研究。形态学上，充盈缺损分为46例凸形和31例凹形。与凸形缺损相比，凹形缺损的增加发生率更高（51.7%对9.4%，P = 0.001）。在61例肺动脉残端充盈缺损中，4例（6.5%）增加的凹形缺损在PET上显示核素浓聚及血管外延伸。凹形、凸形和无充盈缺损组的无进展生存期（PFS）时间差异有统计学意义（对数秩检验P < 0.0001），凹形缺损的生存期最短。多因素Cox比例风险分析表明，充盈缺损的形态在CT早期独立预测PFS（HR：0.46；95%CI：0.39 - 1.99；P = 0.04）。随访中，充盈效应的增长是PFS的独立预测因素（HR：0.26；95%CI：0.11 - 0.65；P = 0.004）。
肺肿瘤切除术后肺动脉残端的某些充盈缺损呈现恶性生长。在CT上充盈缺损早期，凹形独立预测癌症进展，而在随后的随访中，充盈缺损的增长可独立用于预测癌症进展。
