Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring.
Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring.
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DOI：
10.1097/md.0000000000005494
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发表时间：
2016-11
期刊：
影响因子：
1.6
通讯作者：
Moon JI
中科院分区：
文献类型：
--
作者：
Bae K;Jeon KN;Lee SJ;Kim HC;Ha JY;Park SE;Baek HJ;Choi BH;Cho SB;Moon JI
本研究的目的是使用自动肺叶分割和肺气肿量化方法来确定肺气肿和肺癌的肺叶严重程度之间的关系。本研究纳入了78例患者（74例男性和4例女性;平均年龄72岁），这些患者患有以下疾病：病理证实的肺癌、可用于肺叶分割的胸部计算机断层扫描（CT）扫描和肺气肿定量评分。采用定量肺气肿评分法分析肺气肿与肺癌的关系。最常见的癌症位置是左上叶（LUL）（n = 28），其次是右上叶（RUL）（n = 27），左下叶（LLL）（n = 13），右下叶（RLL）（n = 9）和右中叶（RML）（n = 1）。 肺气肿发生率LUL最高，其次为RUL、LLL、RML和RLL。多因素Logistic回归分析显示，肺上叶（OR：1.77，95%CI：1.01-3.11，P = 0.048）和肺气肿发生率排第1或第2位的肺叶（OR：2.48，95%CI：1.48-4.15，P <0.001）与肺癌的发生有显著的独立相关性。 在肺气肿患者中，肺癌倾向于在肺气肿更严重的肺叶中发展。
The aim of this study was to determine the relationship between lobar severity of emphysema and lung cancer using automated lobe segmentation and emphysema quantification methods. This study included 78 patients (74 males and 4 females; mean age of 72 years) with the following conditions: pathologically proven lung cancer, available chest computed tomographic (CT) scans for lobe segmentation, and quantitative scoring of emphysema. The relationship between emphysema and lung cancer was analyzed using quantitative emphysema scoring of each pulmonary lobe. The most common location of cancer was the left upper lobe (LUL) (n = 28), followed by the right upper lobe (RUL) (n = 27), left lower lobe (LLL) (n = 13), right lower lobe (RLL) (n = 9), and right middle lobe (RML) (n = 1). Emphysema ratio was the highest in LUL, followed by that in RUL, LLL, RML, and RLL. Multivariate logistic regression analysis revealed that upper lobes (odds ratio: 1.77; 95% confidence interval: 1.01–3.11, P = 0.048) and lobes with emphysema ratio ranked the 1st or the 2nd (odds ratio: 2.48; 95% confidence interval: 1.48–4.15, P < 0.001) were significantly and independently associated with lung cancer development. In emphysema patients, lung cancer has a tendency to develop in lobes with more severe emphysema.