骨肉瘤肺转移的CT特征与自发性气胸的相关性：一项回顾性分析

Association of CT characteristics of osteosarcoma lung metastases with spontaneous pneumothorax: a retrospective analysis.

作者信息

Li Jianqi, Deng Chengfen, Yuan Jun, Jia Haolin, Peng Lin

机构信息

Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Thorac Dis. 2024 Dec 31;16(12):8417-8423. doi: 10.21037/jtd-24-1015. Epub 2024 Dec 18.

DOI:10.21037/jtd-24-1015

PMID:39831258

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11740071/

Abstract

BACKGROUND

Spontaneous pneumothorax (SP) has been reported to be associated with osteosarcoma lung metastases, but the computed tomography (CT) characteristics of lung metastases in patients with pneumothorax have not been comprehensively described. The study aimed to describe the CT characteristics of lung metastases in patients with osteosarcoma and to identify factors associated with SP.

METHODS

This study comprised 123 patients diagnosed with osteosarcoma lung metastasis at our hospital between January 2016 and December 2021. Demographics, tumor characteristics at initial diagnosis, the time interval between diagnosis of lung metastases and pneumothorax, and features of lung metastases on chest CT were documented.

RESULTS

A total of 31 patients experienced SP (20 unilateral and 11 bilateral cases). Lung metastases were identified as multiple nodules or masses (39/42 123/204, P<0.001), with higher rates of cavitation and pleural involvement (23/42 19/178, P<0.001 and 38/42 63/178, P<0.001, respectively) in patients with pneumothorax. A considerable prevalence of calcification (123/220) was observed in lung metastases. However, no statistically significant difference was found between patients with and without pneumothorax. The duration of detection of lung metastases was shorter in patients with pneumothorax than in those without it (6 11 months, P=0.039). Binary logistic regression analysis revealed that only the presence of cavitation and pleural involvement of lung metastases were significantly associated with pneumothorax, with odds ratios of 12.430 [95% confidence interval (CI): 3.011-51.320; P<0.001] and 15.480 (95% CI: 4.038-59.348; P<0.001), respectively.

CONCLUSIONS

SP can occur in the region of lung metastases near the pleura following the formation and bursting of cavities. Regular follow-up of these patients has the potential to ensure early detection and treatment of pneumothorax.

摘要

背景

自发性气胸（SP）已被报道与骨肉瘤肺转移有关，但气胸患者肺转移的计算机断层扫描（CT）特征尚未得到全面描述。本研究旨在描述骨肉瘤患者肺转移的CT特征，并确定与SP相关的因素。

方法

本研究纳入了2016年1月至2021年12月期间在我院诊断为骨肉瘤肺转移的123例患者。记录了患者的人口统计学信息、初始诊断时的肿瘤特征、肺转移诊断与气胸之间的时间间隔以及胸部CT上肺转移的特征。

结果

共有31例患者发生SP（20例单侧，11例双侧）。肺转移表现为多发结节或肿块（39/42对123/204，P<0.001），气胸患者的空洞形成率和胸膜受累率更高（分别为23/42对19/178，P<0.001和38/42对63/178，P<0.001）。在肺转移灶中观察到相当高的钙化发生率（123/220）。然而，气胸患者和非气胸患者之间未发现统计学上的显著差异。气胸患者肺转移的检测持续时间比无气胸患者短（6±11个月，P=0.039）。二元逻辑回归分析显示，只有肺转移灶的空洞形成和胸膜受累与气胸显著相关，优势比分别为12.430[95%置信区间（CI）：3.011-51.320；P<0.001]和15.480（95%CI：4.038-59.348；P<0.001）。