肺肿瘤切除后 CT 上的肺血管残端充盈缺损:癌症进展的预测因子。
The pulmonary-vascular-stump filling defect on CT post lung tumor resection: a predictor of cancer progression.
发表日期:2024 Jul 16
作者:
Lei Ni, Qihui Wang, Yilong Wang, Yaqi Du, Zhenggang Sun, Guoguang Fan, Ce Li, Guan Wang
来源:
CANCER IMAGING
摘要:
探讨CT上肺血管残端充盈缺损情况,并探讨其与癌症进展的关系。对我们机构数据库中2018年至2022年的记录进行回顾性分析,以识别肺癌切除术后肺血管残端的充盈缺损情况,并探讨其与癌症进展的关系。收集患者的影像学和临床数据。在分析的1714例患者中,发现95例肺癌切除后血管残端充盈缺损。排除失访病例后,最终研究共纳入77例。从形态上看,充盈缺损分为凸形 46 例和凹形 31 例。与凸形缺陷相比,凹形缺陷的增加发生率更高(51.7% vs. 9.4%,P = 0.001)。在肺动脉残端的 61 个充盈缺损中,有 4 个(6.5%)增加的凹形缺损显示 PET 上的核素浓度和血管外延伸。凹形缺损组、凸形缺损组和非充盈缺损组的无进展生存(PFS)时间存在显着差异(对数秩P < 0.0001),凹形缺损组的生存时间最短。多变量Cox比例风险分析表明,CT上充盈缺损的形状独立预测发病早期的PFS(HR:0.46;95%CI:0.39-1.99;P = 0.04)。在随访中,充盈效应的增长是 PFS 的独立预测因子(HR:0.26;95% CI:0.11-0.65;P = 0.004)。肺肿瘤切除后肺动脉残端的某些充盈缺陷表现出恶性生长。在CT上充盈缺损的早期发作中,凹形独立预测癌症进展,而在随后的随访期间,充盈缺损的增长可以独立地用于预测癌症进展。©2024。作者(s)。
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.© 2024. The Author(s).