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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年06期

页码:

925-930

栏目:

论著

出版日期:

2024-12-25

文章信息/Info

Title:

Impact of different previous cancer history on the diagnostic efficiency of PNI-GARS and Lung-RADS

作者:

宋飞鹏¹; 2; 王盈升³; 许洪波¹; 吕发金¹

400010 重庆,重庆医科大学附属第一医院放射科¹
030001 太原,山西医科大学第二医院放射科²
030607 晋中,山西医科大学³

Author(s):

Song Feipeng¹; 2;  Wang Yingsheng³;  Xu Hongbo¹;  Lv Fajin¹.

¹Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China; ²Department of Radiology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, China; ²Shanxi Medical University, Jinzhong 030607, China

关键词:

肺结节;  体层摄影术; X线计算机;  肺部影像报告和数据系统

Keywords:

Pulmonary nodule;  Tomography;  X-ray computed;  Lung imaging-reporting and data system

分类号:

R734.2

DOI:

10.3877/cma.j.issn.1674-6902.2024.06.013

摘要:

目的 分析既往恶性肿瘤病史、既往恶性肿瘤来源对肺部影像报告和数据系统(lung imaging-reporting and data system, Lung-RADS)2022版及肺结节影像分级评估系统(pulmonary node imaging-grading and reporting system, PNI-GARS)对肺结节诊断的影响。方法 选择2018年1月至2021年11月我院收治的既往有癌症病史行肺结节切除术者451例,收集患者胸部CT影像和临床资料,依据Lung-RADS和PNI-GARS进行分类或分级判断。根据罹患癌症种类不同分为既往肺癌(prior lung cancer, PLC)组144例和既往肺外癌(prior extrapulmonary cancer, PEPC)组307例。术后组织病理判断Lung-RADS和PNI-GARS诊断一致率(agreement rate, AR),比较两种系统的诊断AR及不同肺结节类型占比。结果 451例565枚肺结节, PLC组既往癌症病史<5年135例,175枚肺结节; 既往癌症病史≥5年9例,12枚肺结节。PEPC组既往癌症病史<5年219例,278枚肺结节; 既往癌症病史≥5年88例,100枚肺结节。Lung-RADS对部分实性结节诊断AR 93.0% 和实性结节88.1% 接近(P=0.131),高于磨玻璃密度结节24.0%(P<0.001)。PNI-GARS对部分实性结节诊断AR高达100%(P<0.001),对实性结节与磨玻璃密度结节的诊断AR相似(88.5% vs. 84.8%)(P=0.273)。Lung-RADS评价既往癌症病史<5年不同类型肺结节PLC组诊断AR 58.9%, PEPC组76.6%(P<0.001); PLC组(≥5年)vs. PEPC(≥5年); PLC(<5年)vs. PLC(≥5年); PEPC(<5年)vs. PEPC(≥5年)肺结节诊断AR相似(P>0.05)。不同组PNI-GARS的诊断AR差异无统计学意义,与既往癌症病史、既往恶性肿瘤类型无关。结论 既往癌症病史和既往恶性肿瘤类型不影响PNI-GARS诊断,既往癌症病史可能影响Lung-RADS诊断。

Abstract:

Objective To investigate the effect of the length and source of malignancy history on the diagnostic efficacy of Lung-RADS(lung imaging-reporting and data system)2022 and PNI-GARS(pulmonary node imaging-grading and reporting system)in pulmonary nodules(PNs). Methods Chest computed tomography and clinical data of PNs in 451 patients with a history of cancer who underwent surgical resection in The First Affiliated Hospital of Chongqing Medical University from January, 2018, to November, 2021, were retrospectively collected and evaluated based on Lung-RADS and PNI-GARS, respectively. All PNs were divided into 2 groups: the prior lung cancer(PLC)144 cases and the prior extrapulmonary cancer(PEPC)groups 307cases. The diagnostic agreement rate(AR)of Lung-RADS and PNI-GARS was evaluated based on the pathological diagnosis of nodules after operation. The AR of the two systems and the composition ratios of PNs with different types between different groups were calculated and compared. Results A total of 451 patients with 565 PNs were included in this study. These patients were divided into the PLC group(<5 years: 135 cases, 175 PNs; ≥5 years: 9 cases, 12 PNs)and the PEPC group(<5 years: 219 cases, 278 PNs; ≥5 years: 88 cases, 100 PNs). The diagnostic AR of Lung-RADS of partial solid nodules(93.0%)and solid nodules(88.1%)was close(P=0.131), while both were higher than that of the ground-glass nodules(24.0%, all P values <0.001). However, the diagnostic AR of PNI-GARS of partial solid nodules was the highest(100%, all P<0.001), and the AR of solid nodules and ground glass nodules were similar with each other(88.5% vs. 84.8%, P=0.273). Within 5 years, the composition ratio of PNs and the diagnostic AR of Lung-RADS(PLC: 58.9%, PEPC: 76.6%)between the PLC and PEPC groups were all different(all P values<0.001), and the others(composition ratio of PNs & the diagnostic AR: PLC(≥5 years)vs. PEPC(≥5 years); PLC(<5 years)vs. PLC(≥5 years); PEPC(<5 years)vs. PEPC(≥5 years)were similar(all P values >0.05). On the contrary, the diagnostic AR for PNI-GARS did not vary regardless of the length of previous cancer history or the type of previous malignancy. Conclusion The diagnostic efficiency of PNI-GARS would not be affected by the length of previous cancer history and the origin of previous malignancy, and the length of prior cancer history may impact the diagnostic performance of Lung-RADS.

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备注/Memo

备注/Memo:

基金项目: 重庆市技术创新与应用发展专项重点项目(CSTC2021jscx-gksb-N0030)
重庆市科卫联合医学研究计划(2022ZDXM006)
重庆市卫生适宜技术推广项目(2023jstg044)
通信作者: 吕发金, Email: fajinlv@sohu.com

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更新日期/Last Update: 2024-12-25