Zulli Andrea, Tocchioni Francesca, Oreglio Chiara, Caporalini Chiara, Buccoliero Anna Maria, Morabito Antonino, Morini Francesco
Department of Pediatric Thoracic Neonatal and Urological Surgery, Meyer Children's Hospital IRCCS, Viale G.Pieraccini 24, 50139, Florence, Italy.
Neurofarba Department, University of Florence, Florence, Italy.
Pediatr Surg Int. 2024 Dec 15;41(1):28. doi: 10.1007/s00383-024-05931-6.
Patients with congenital lung malformation (CLM) may present pulmonary inflammatory changes. However, little is known about the factors influencing local inflammation. The aim of this study was to evaluate the factors that may affect inflammatory changes in CLM.
Patients with CLM operated upon between 2005 and 2021 were included. The grade of inflammation was defined with a purpose-made inflammatory score (IS) ranging from 0 to 5. The association of type of CLM and age at surgery with IS was analyzed. Results are means (standard deviation).
Data from 105 patients with CLM were collected, 56 had congenital pulmonary airways malformation (CPAM), 24 bronchopulmonary sequestration (BPS), and 25 congenital lobar emphysema (CLE). 91 patients (87%) had inflammatory changes. IS was 2.1 (1.5), 1.2 (1.0), and 1.3 (1.5) in CPAM, BPS, and CLE respectively (One-way ANOVA p = 0.0101). CPAM showed a significantly higher IS as compared with BPS (p = 0.0242) and CLE (p = 0.0495). Age at operation significantly correlated to IS (r = 0.14; p < 0.0001). Patients aged below 6 months at operation had lower IS [1.4 (1.2)] as compared to those over 6 months [2.0 (1.6)] (p = 0.018). Age at operation significantly correlated with the IS in CPAM (r = 0.17; p = 0.0016) and CLE (r = 0.47; p < 0.0001) patients.
Patients with CLMs often present inflammatory changes in their lungs. Grade of inflammation significantly correlates with age at surgery and type of anomaly, with CPAMs having the highest grade. These findings support early resection in patients with CLM, especially in case of CPAM.
先天性肺发育畸形（CLM）患者可能出现肺部炎症改变。然而，关于影响局部炎症的因素知之甚少。本研究的目的是评估可能影响CLM炎症改变的因素。
纳入2005年至2021年间接受手术治疗的CLM患者。炎症程度用特制的炎症评分（IS）定义，范围为0至5分。分析CLM类型和手术年龄与IS的相关性。结果以均值（标准差）表示。
收集了105例CLM患者的数据，其中56例为先天性肺气道畸形（CPAM），24例为支气管肺隔离症（BPS），25例为先天性肺叶气肿（CLE）。91例患者（87%）有炎症改变。CPAM、BPS和CLE的IS分别为2.1（1.5）、1.2（1.0）和1.3（1.5）（单因素方差分析p = 0.0101）。与BPS（p = 0.0242）和CLE（p = 0.0495）相比，CPAM的IS显著更高。手术年龄与IS显著相关（r = 0.14；p < 0.0001）。手术时年龄小于6个月的患者IS较低[1.4（1.2）]，而年龄大于6个月的患者IS较高[2.0（1.6）]（p = 0.018）。手术年龄与CPAM（r = 0.17；p = 0.0016）和CLE（r = 0.47；p < 0.0001）患者的IS显著相关。
CLM患者肺部常出现炎症改变。炎症程度与手术年龄和畸形类型显著相关，CPAM的炎症程度最高。这些发现支持对CLM患者尽早进行手术切除，尤其是CPAM患者。
