Prognostic impact of nomogram based on whole tumour size, tumour disappearance ratio on CT and SUVmax on PET in lung adenocarcinoma
Prognostic impact of nomogram based on whole tumour size, tumour disappearance ratio on CT and SUVmax on PET in lung adenocarcinoma
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DOI：
10.1007/s00330-015-4029-0
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发表时间：
2016-06-01
影响因子：
5.9
通讯作者：
Shim, Young Mog
中科院分区：
文献类型：
--
作者：
Song, So Hee;Ahn, Joong Hyun;Shim, Young Mog
肺腺癌常表现为亚实性结节，CT上的实性部分和磨玻璃影（GGO）部分具有不同的预后意义。因此，当前的 T 描述符（定义为整个肿瘤直径，不区分实性和 GGO）是不够的。我们的目的是确定实体瘤大小的预后意义，并尝试纳入预后因素，例如 CT 上的肿瘤消失率 (TDR) 和 PET/CT 上的 SUVmax。对 595 例完全切除的肺腺癌患者进行了分析。我们使用整个肿瘤大小、TDR 和 SUVmax 开发了列线图。在另外 102 名患者中进行了外部验证。在肿瘤测量为千分之一 2 cm 和 > 2 至 3 cm 的患者中，无病生存 (DFS) 与实体瘤大小显着相关 (P < 0.001)，但与整个肿瘤大小无关 (P = 0.052)。在患者生存分层方面，开发的列线图显着优于传统 T 分期（生存 ROC 曲线下面积；净重分类改进 P = 0.013）。在外部验证组中，根据建议的 T 分期，DFS 存在显着差异（P = 0.009）。基于列线图的 T 描述符比传统 T 描述符提供更好的生存预测和个体风险评估。aEuro cent 目前对整个肿瘤直径（包括毛玻璃不透明度）的测量不足 aEuro cent TDR 能够区分侵入性实性部分和非侵入性 GGO 部分 aEuro cent SUVmax 证明了肿瘤的生物侵袭性 Eurocent 我们开发了使用整个肿瘤大小、TDR 和 SUVmaxaEuro cent 基于列线图的临床 T 描述符的列线图可提供更好的生存预测。
Lung adenocarcinoma frequently manifests as subsolid nodules, and the solid portion and ground-glass-opacity (GGO) portion on CT have different prognostic significance. Therefore, current T descriptor, defined as the whole tumour diameter without discrimination between solid and GGO, is insufficient. We aimed to determine the prognostic significance of solid tumour size and attempt to include prognostic factors such as tumour disappearance rate (TDR) on CT and SUVmax on PET/CT.Five hundred and ninety-five patients with completely resected lung adenocarcinoma were analyzed. We developed a nomogram using whole tumour size, TDR, and SUVmax. External validation was performed in another 102 patients.In patients with tumours measuring a parts per thousand currency sign2 cm and > 2 to 3 cm, disease free survival (DFS) was significantly associated with solid tumour size (P < 0.001), but not with whole tumour size (P = 0.052). Developed nomogram was significantly superior to the conventional T stage (area under the curve of survival ROC; P = 0.013 by net reclassification improvement) in stratification of patient survival. In the external validation group, significant difference was noted in DFS according to proposed T stage (P = 0.009).Nomogram-based T descriptors provide better prediction of survival and assessment of individual risks than conventional T descriptors.aEuro cent Current measurement of whole tumour diameter including ground-glass opacity is insufficientaEuro cent TDR enables differentiation between invasive solid portion and non-invasive GGO portionaEuro cent SUVmax demonstrates the biological aggressiveness of the tumouraEuro cent We developed a nomogram using whole tumour size, TDR, and SUVmaxaEuro cent Nomogram-based clinical T descriptors provide better prediction of survival.