Clinical predictors of metastatic disease to the brain from non small cell lung carcinoma: Primary tumor size, cell type, and lymph node metastases
Clinical predictors of metastatic disease to the brain from non small cell lung carcinoma: Primary tumor size, cell type, and lymph node metastases
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DOI：
10.1148/radiol.2423051707
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发表时间：
2007-03-01
期刊：
影响因子：
19.7
通讯作者：
Raftopoulos, Haralambos
中科院分区：
文献类型：
--
作者：
Mujoomdar, Amol;Austin, John H. M.;Raftopoulos, Haralambos
目的：回顾性评估可能的临床预测转移性疾病的脑在非小细胞肺癌（NSCLC）患者。材料和方法：机构审查委员会批准获得，知情同意书被免除，并获得数据和其他信息之前，实施健康保险责任法案。对264例接受胸部和头部影像学检查的NSCLC患者（平均年龄65岁; 158例男性和106例女性）进行了审查。分层Logistic回归被用来确定作为患者的年龄和性别的功能，大小，细胞类型，外周与中央位置，和淋巴结分期的原发性NSCLC的预测概率转移到大脑。结果：95（36%）例患者有转移性疾病的证据，以大脑。原发性肿瘤的平均直径为4.0 cm +/- 2.2（标准差）。细胞类型包括腺癌（136例[52%]患者），未分化（68例[26%]患者）和鳞状（47例[18%]患者），其中脑转移性疾病分别发生在43%，41%和13%（P = 0.003）的患者中。预测的脑转移概率与原发肿瘤的大小（P <0.001）、细胞类型（腺癌和未分化vs鳞状细胞，P = 0.001）和淋巴结分期（P <0.017）呈正相关，但与年龄、性别或原发肿瘤部位无关。对于无淋巴结扩散的原发性腺癌，2 cm和6 cm原发性肿瘤转移至脑的预测概率为0.14（95%置信区间：.06，.27）和.72（95%置信区间：0.48，0.88）结论：原发性非小细胞肺癌脑转移的概率与原发肿瘤的大小、细胞类型和胸内淋巴结分期有关。(c)RSNA，2007年。
Purpose: To retrospectively assess possible clinical predictors of metastatic disease to the brain in patients with non-small cell lung carcinoma (NSCLC).Materials and Methods: Institutional review board approval was obtained, informed consent was waived, and data and other information were obtained prior to implementation of HIPAA. A review was performed of 264 patients (mean age, 65 years; 158 men and 106 women) with NSCLC who had undergone imaging studies of the chest and head. Hierarchical logistic regression was used to determine the predicted probability of metastatic disease to the brain as a function of patient age and sex and of size, cell type, peripheral versus central location, and lymph node stage of the primary NSCLC.Results: Ninety-five (36%) patients had evidence of metastatic disease to the brain. Mean diameter of the primary tumors was 4.0 cm +/- 2.2 (standard deviation). Cell types included adenocarcinoma (136 [52%] patients), undifferentiated (68 [26%] patients), and squamous (47 [18%] patients), for which metastatic disease to the brain occurred in 43%, 41%, and 13% (P = .003) of patients, respectively. The predicted probability of metastatic disease to the brain correlated positively with size of the primary tumor (P < .001), cell type (adenocarcinoma and undifferentiated vs squamous, P = .001), and lymph node stage (P < .017) but did not correlate with age, sex, or primary tumor location. For primary adenocarcinoma without lymph node spread, the predicted probabilities of metastatic disease to the brain from 2-and 6-cm primary tumors were .14 (95% confidence interval: .06, .27) and.72 (95% confidence interval: .48, .88), respectively (P < .02).Conclusion: The probability of metastatic disease to the brain from primary NSCLC is correlated with size of the primary tumor, cell type, and intrathoracic lymph node stage. (c) RSNA, 2007.