背景与目的肺浸润性黏液腺癌(invasive mucinous adenocarcinoma of the lung,IMA)是肺腺癌中一种少见且特殊的类型,该类肿瘤的特点往往是少有淋巴结转移,因此对于该类肿瘤的预后评估依靠现有的肿瘤原发灶-淋巴结-转移(tumor-node-metas...背景与目的肺浸润性黏液腺癌(invasive mucinous adenocarcinoma of the lung,IMA)是肺腺癌中一种少见且特殊的类型,该类肿瘤的特点往往是少有淋巴结转移,因此对于该类肿瘤的预后评估依靠现有的肿瘤原发灶-淋巴结-转移(tumor-node-metastasis,TNM)分期存在困难。本研究的目的是构建列线图来预测术后淋巴结阴性的IMA患者的预后。方法根据纳入标准和排除标准,回顾性分析2012年7月至2017年5月宁波大学附属李惠利医院(训练队列,n=78)和宁波市第二医院(验证队列,n=66)胸外科收治的术后病理为淋巴结阴性的IMA患者的资料,分析训练队列的临床病理特征的预后价值并建立预后预测模型,并对模型性能进行评价,最后将验证队列的数据代入进行外部验证。结果单因素分析显示肺炎型、较大的肿块、包含黏液和非黏液成分的混合型、较高的总分期是5年无进展生存期(progression-free survival,PFS)及总生存期(overall survival,OS)的影响因素。多因素分析进一步表明,影像学分型、肿块大小、黏液成分是5年PFS及OS的独立预后因素。5年PFS率和OS率分别为62.82%和75.64%,亚组的生存分析显示,肺炎型和包含黏液和非黏液成分的混合型IMA患者的5年PFS及OS分别明显低于孤立型和纯黏液型IMA患者。5年PFS和OS的Harrell’s C指数分别为0.815(95%CI:0.741-0.889)和0.767(95%CI:0.669-0.865),这两个模型的校准曲线及决策曲线分析(decision curve analysis,DCA)在两个队列中显示出良好的预测性能。结论本次基于临床病理特征构建的列线图在一定程度上可以作为IMA切除术后淋巴结阴性患者的一种有效预后预测工具。展开更多
近年来,随着医疗技术水平的提高,以及人们健康意识的不断增强,越来越多的肺磨玻璃结节能够被更早地检出,但在全球范围内,肺癌的发病率与死亡率居高不下,一直是全球主要的危及生命的恶性肿瘤。胸部CT作为目前安全且有效的肺癌早期筛查手...近年来,随着医疗技术水平的提高,以及人们健康意识的不断增强,越来越多的肺磨玻璃结节能够被更早地检出,但在全球范围内,肺癌的发病率与死亡率居高不下,一直是全球主要的危及生命的恶性肿瘤。胸部CT作为目前安全且有效的肺癌早期筛查手段,不仅能够及时地对肺癌高危人群进行筛查,降低死亡率,而且检查技术手段无创、安全、高效。充分且合理地运用CT,不仅可以防止过度医疗的行为,减轻患者负担,同时也能使肺癌的患者得到尽早的治疗以获得最佳的预后。In recent years, with the improvement of medical technology and the continuous enhancement of people’s health awareness, more and more ground-glass nodules in the lungs can be detected earlier, but the incidence and mortality of lung cancer remain high in the world, and it has always been the main life-threatening malignant tumor in the world. As a safe and effective early screening method for lung cancer, chest CT can not only screen high-risk groups of lung cancer in a timely manner and reduce mortality, but also be non-invasive, safe and efficient. Adequate and rational use of CT can not only prevent excessive medical treatment and reduce the burden on patients, but also enable patients with lung cancer to receive early treatment for the best prognosis.展开更多
文摘近年来,随着医疗技术水平的提高,以及人们健康意识的不断增强,越来越多的肺磨玻璃结节能够被更早地检出,但在全球范围内,肺癌的发病率与死亡率居高不下,一直是全球主要的危及生命的恶性肿瘤。胸部CT作为目前安全且有效的肺癌早期筛查手段,不仅能够及时地对肺癌高危人群进行筛查,降低死亡率,而且检查技术手段无创、安全、高效。充分且合理地运用CT,不仅可以防止过度医疗的行为,减轻患者负担,同时也能使肺癌的患者得到尽早的治疗以获得最佳的预后。In recent years, with the improvement of medical technology and the continuous enhancement of people’s health awareness, more and more ground-glass nodules in the lungs can be detected earlier, but the incidence and mortality of lung cancer remain high in the world, and it has always been the main life-threatening malignant tumor in the world. As a safe and effective early screening method for lung cancer, chest CT can not only screen high-risk groups of lung cancer in a timely manner and reduce mortality, but also be non-invasive, safe and efficient. Adequate and rational use of CT can not only prevent excessive medical treatment and reduce the burden on patients, but also enable patients with lung cancer to receive early treatment for the best prognosis.
