Estimation of lung cancer risk using homology-based emphysema quantification in patients with lung nodules
Estimation of lung cancer risk using homology-based emphysema quantification in patients with lung nodules
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DOI：
10.1371/journal.pone.0210720
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发表时间：
2019-01-22
期刊：
影响因子：
3.7
通讯作者：
Togashi, Kaori
中科院分区：
文献类型：
--
作者：
Nishio, Mizuho;Kubo, Takeshi;Togashi, Kaori
本研究的目的是评估是否同源性为基础的肺气肿定量（HEQ）与肺癌的风险显着相关。这项回顾性研究得到了我们机构审查委员会的批准。我们纳入了576例肺结节患者（317例男性和259例女性;年龄66.8 ± 12.3岁），这些患者是从先前生成的计算机辅助诊断数据库中选择的。其中，283例被诊断为肺癌，而其余293例显示为良性肺结节。进行HEQ，并根据计算机断层扫描计算低衰减肺面积百分比（LAA%）。使用逻辑回归构建统计模型以估计肺癌风险;性别、年龄、吸烟史（Brinkman指数）、LAA%和HEQ被视为自变量。评价了以下三个模型：基础模型（性别、年龄和吸烟史）; LAA%模型（基础模型+ LAA%）;和HEQ模型（基础模型+ HEQ）。使用受试者操作特征分析和相关曲线下面积（AUC）评估模型性能。使用Delong检验评价模型之间AUC的差异。基础、LAA%和HEQ模型的AUC分别为0.585、0.593和0.622。HEQ系数在HEQ模型中具有统计学显著性（P = 0.00487），但LAA%系数在LAA%模型中不具有统计学显著性（P = 0.199）。Delong检验显示LAA%和HEQ模型之间AUC存在显著差异（P = 0.0455）。总之，在调整年龄，性别和吸烟史（Brinkman指数）后，HEQ与肺癌风险显著相关。
The purpose of this study was to assess whether homology-based emphysema quantification (HEQ) is significantly associated with lung cancer risk. This retrospective study was approved by our institutional review board. We included 576 patients with lung nodules (317 men and 259 women; age, 66.8 +/- 12.3 years), who were selected from a database previously generated for computer-aided diagnosis. Of these, 283 were diagnosed with lung cancer, whereas the remaining 293 showed benign lung nodules. HEQ was performed and percentage of low-attenuation lung area (LAA%) was calculated on the basis of computed tomography scans. Statistical models were constructed to estimate lung cancer risk using logistic regression; sex, age, smoking history (Brinkman index), LAA%, and HEQ were considered independent variables. The following three models were evaluated: the base model (sex, age, and smoking history); the LAA% model (the base model + LAA%); and the HEQ model (the base model + HEQ). Model performance was assessed using receiver operating characteristic analysis and the associated area under the curve (AUC). Differences in AUCs among the models were evaluated using Delong's test. AUCs of the base, LAA%, and HEQ models were 0.585, 0.593, and 0.622, respectively. HEQ coefficient was statistically significant in the HEQ model (P = 0.00487), but LAA% coefficient was not significant in the LAA% model (P = 0.199). Delong's test revealed significant difference in AUCs between the LAA% and HEQ models (P = 0.0455). In conclusion, after adjusting for age, sex, and smoking history (Brinkman index), HEQ was significantly associated with lung cancer risk.