文章：

通过计算机断层扫描预测切除肺腺癌中的脏层胸膜侵犯

Predicting Visceral Pleural Invasion in Resected Lung Adenocarcinoma via Computed Tomography

原文发布日期：23 April 2025

DOI: 10.3390/cancers17091414

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: For thoracic surgeons, the extent of visceral pleural invasion is a crucial consideration in the surgical approach to adenocarcinoma; this invasion may influence the extent of surgical resection and predict prognosis. With advances in preoperative imaging technology, predicting visceral pleural invasion via computed tomography (CT) characteristics may be feasible. The aim of this study was to evaluate the association between CT characteristics and visceral pleural invasion in patients with surgically resected lung adenocarcinoma. Methods: Patients with lung adenocarcinoma who underwent curative lung tumor resection (n = 643) were retrospectively included in this study between January 2011 and December 2015. Basic demographic CT images were analyzed by experienced thoracic surgeons and radiologists. Postoperative pathology reports were confirmed by experienced pathologists. Univariate and multivariate analyses were performed for potential prognostic factors. Results: Potential visceral pleural invasion characteristics of preoperative CT included tumor size (cm), solid part size, pleural contact of arch distance, ground glass opacity (%), tumor shape, border type, distance from visceral pleura, depth, and invasion site. In addition, solid part size, ground glass opacity (%), consolidation to tumor ratio (%), tumor shape, border type, distance from visceral pleura, and invasion site showed statistical significance for prognosis. Conclusions: Increased precision of image interpretation may provide more predictive clues to improve the identification of visceral pleural invasion before operations. The extent of surgical resection may be more accurately determined, and systemic treatment may be administered earlier for those with poor prognostic factors.

摘要翻译： 

背景/目的：对于胸外科医生而言，内脏胸膜侵犯程度是肺腺癌手术方案制定的关键考量因素，其可能影响手术切除范围并预测预后。随着术前影像技术的进步，通过计算机断层扫描（CT）特征预测内脏胸膜侵犯具有可行性。本研究旨在评估手术切除肺腺癌患者的CT特征与内脏胸膜侵犯之间的关联。方法：本研究回顾性纳入2011年1月至2015年12月期间接受根治性肺肿瘤切除术的肺腺癌患者（n=643）。由经验丰富的胸外科医生和放射科医师分析基础人口统计学CT图像，术后病理报告由资深病理医师确认。对潜在预后因素进行单变量和多变量分析。结果：术前CT提示潜在内脏胸膜侵犯的特征包括肿瘤大小（cm）、实性部分大小、胸膜接触弓形距离、磨玻璃影比例（%）、肿瘤形态、边界类型、距脏层胸膜距离、侵犯深度及侵犯部位。此外，实性部分大小、磨玻璃影比例（%）、实变与肿瘤比值（%）、肿瘤形态、边界类型、距脏层胸膜距离及侵犯部位对预后具有统计学意义。结论：提高影像判读精度可为术前更准确识别内脏胸膜侵犯提供更多预测线索，有助于更精准确定手术切除范围，并对存在不良预后因素的患者更早实施系统性治疗。

原文链接：

Predicting Visceral Pleural Invasion in Resected Lung Adenocarcinoma via Computed Tomography