胸膜癌胚抗原和最大标准化摄取值作为临床 T1N0M0 肺腺癌内脏胸膜侵犯的预测指标

Q4 Medicine Journal of Chest Surgery Pub Date : 2024-01-05 DOI:10.5090/jcs.23.094
Hye Rim Na, Seok Whan Moon, Kyung Soo Kim, Mi Hyoung Moon, Kwanyong Hyun, Seung Keun Yoon
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引用次数: 0

摘要

背景:内脏胸膜侵犯(VPI)是一个预后不良的因素,会导致早期肺癌的分期升高。然而,术前评估 VPI 是一项挑战。本研究旨在检测术中胸膜癌胚抗原(pCEA)水平和最大标准化摄取值(SUVmax)作为临床T1N0M0肺腺癌患者VPI的预测指标:对 613 名接受术中 pCEA 取样和肺切除术的非小细胞肺癌患者的病历进行了回顾性分析。其中,390 人属于临床 I 期腺癌,肿瘤≤30 毫米。根据计算机断层扫描结果,这些患者被分为胸膜接触组(186 人)和非胸膜接触组(204 人)。通过构建接收器操作特征曲线(ROC)来分析 pCEA 和 SUVmax 与 VPI 的关系。此外,还进行了逻辑回归分析,以评估各组 VPI 的风险因素:ROC曲线分析显示,pCEA水平大于2.565纳克/毫升(曲线下面积[AUC]=0.751)和SUVmax高于4.25(AUC=0.801)对胸膜接触患者的VPI具有高度预测性。基于多变量分析,pCEA(几率比[OR],3.00;95%置信区间[CI],1.14-7.87;P=0.026)和SUVmax(OR,5.25;95% CI,1.90-14.50;P=0.001)是胸膜接触组VPI的显著风险因素:结论:对于出现胸膜接触的临床I期肺腺癌患者,pCEA和SUVmax是VPI的潜在预测指标。这些指标可能有助于制定肺癌手术计划。
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Pleural Carcinoembryonic Antigen and Maximum Standardized Uptake Value as Predictive Indicators of Visceral Pleural Invasion in Clinical T1N0M0 Lung Adenocarcinoma.

Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma.

Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group.

Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14-7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90-14.50; p=0.001) were significant risk factors for VPI in the pleural contact group.

Conclusion: In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

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来源期刊
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
期刊最新文献
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