目的:根据FleischnerSociety的定义,评估自动量化间质性肺异常(ILA)在可切除的非小细胞肺癌(NSCLC)患者中的预后意义。
方法:回顾性纳入2015年1月至2019年12月接受肺叶切除术或肺切除术治疗NSCLC的患者。使用市售的基于深度学习的ILA自动定量软件分析术前CT扫描。根据弗莱施纳学会的量化结果和定义以及多学科的讨论,患者分为正常,ILA,和间质性肺病(ILD)组。
结果:在1524名患者中,87(5.7%)和20(1.3%)患者患有ILA和ILD,分别。两个ILA(HR,1.81;95%CI:1.25-2.61;p=.002)和ILD(HR,5.26;95%CI:2.99-9.24;p<.001)组无复发生存率(RFS)较差。随着疾病严重程度的增加,总生存期(OS)降低(ILA组的HR2.13[95%CI:1.27-3.58;p=.004]和ILD组的7.20[95%CI:3.80-13.62,p<.001])。定量的纤维化和非纤维化ILA成分均与不良RFS(HR,1.57;95%CI:1.12-2.21;p=0.009;和HR,1.11;95%CI:1.01-1.23;p=.03)和OS(HR,1.59;95%CI:1.06-2.37;p=.02;和HR,1.17;95%CI:1.03-1.33;p=0.01)在正常组和ILA组中。
结论:基于FleischnerSociety定义的ILA自动CT定量可根据疾病类别和定量的纤维化和非纤维化ILA成分预测可切除肺癌患者的预后。
结论:ILA的定量CT评估为肺癌术后患者提供了预后信息,这有助于考虑积极监测复发,特别是在那些具有较大程度的量化ILA。
结论:•在1524例可切除的肺癌患者中,1417例(93.0%)患者被归类为正常,87(5.7%)为间质性肺异常(ILA),20例(1.3%)为间质性肺病(ILD)。•ILA和ILD组均与无复发生存率不良相关(风险比[HR],1.81,p=0.002;HR,分别为5.26,p<.001)和总生存率(HR,2.13;p=.004;HR,7.20;p<.001)。•定量的纤维化和非纤维化ILA组分均与正常和ILA组中的无复发存活和总存活相关。
OBJECTIVE: To assess the prognostic significance of automatically quantified interstitial lung abnormality (ILA) according to the definition by the Fleischner Society in patients with resectable non-small-cell lung cancer (NSCLC).
METHODS: Patients who underwent lobectomy or pneumonectomy for NSCLC between January 2015 and December 2019 were retrospectively included. Preoperative CT scans were analyzed using the commercially available deep-learning-based automated quantification software for ILA. According to quantified results and the definition by the Fleischner Society and multidisciplinary discussion, patients were divided into normal, ILA, and interstitial lung disease (ILD) groups.
RESULTS: Of the 1524 patients, 87 (5.7%) and 20 (1.3%) patients had ILA and ILD, respectively. Both ILA (HR, 1.81; 95% CI: 1.25-2.61; p = .002) and ILD (HR, 5.26; 95% CI: 2.99-9.24; p < .001) groups had poor recurrence-free survival (RFS). Overall survival (OS) decreased (HR 2.13 [95% CI: 1.27-3.58; p = .004] for the ILA group and 7.20 [95% CI: 3.80-13.62, p < .001] for the ILD group) as the disease severity increased. Both quantified fibrotic and non-fibrotic ILA components were associated with poor RFS (HR, 1.57; 95% CI: 1.12-2.21; p = .009; and HR, 1.11; 95% CI: 1.01-1.23; p = .03) and OS (HR, 1.59; 95% CI: 1.06-2.37; p = .02; and HR, 1.17; 95% CI: 1.03-1.33; and p = .01) in normal and ILA groups.
CONCLUSIONS: The automated CT quantification of ILA based on the definition by the Fleischner Society predicts outcomes of patients with resectable lung cancer based on the disease category and quantified fibrotic and non-fibrotic ILA components.
CONCLUSIONS: Quantitative CT assessment of ILA provides prognostic information for lung cancer patients after surgery, which can help in considering active surveillance for recurrence, especially in those with a larger extent of quantified ILA.
CONCLUSIONS: • Of the 1524 patients with resectable lung cancer, 1417 (93.0%) patients were categorized as normal, 87 (5.7%) as interstitial lung abnormality (ILA), and 20 (1.3%) as interstitial lung disease (ILD). • Both ILA and ILD groups were associated with poor recurrence-free survival (hazard ratio [HR], 1.81, p = .002; HR, 5.26, p < .001, respectively) and overall survival (HR, 2.13; p = .004; HR, 7.20; p < .001). • Both quantified fibrotic and non-fibrotic ILA components were associated with recurrence-free survival and overall survival in normal and ILA groups.