■探讨嗜酸性粒细胞慢性阻塞性肺疾病(COPD)患者的定量计算机断层扫描(QCT)参数的特征和诊断性能。
■回顾性分析COPD患者的高分辨率CT扫描,和各种肺气肿实质测量,包括肺容量(LC),肺平均密度(LMD),肺标准偏差(LSD),全宽半最大值(FWHM),进行肺相对体素数(LRVN)。比较嗜酸性粒细胞和非嗜酸性粒细胞COPD患者的QCT参数,使用嗜酸性粒细胞COPD的定义是血液嗜酸性粒细胞值≥300个细胞·µL-1至少3次。使用受试者工作特征曲线和曲线下面积(ROC-AUC)和python来评估QCT的鉴别功效。
■非嗜酸性COPD患者的TLMD(-846.3±47.9HounsfieldUnit[HU])和TFWHM(162.5±30.6HU)明显低于嗜酸性COPD患者(-817.8±54.4,177.3±33.1HU,分别)(p=0.018、0.03)。此外,嗜酸性COPD组的总LC(TLC)和TLSD显着降低(3234.4±1145.8,183.8±33.9HU,分别)与非嗜酸性粒细胞COPD组(5600.2±1248.4,203.5±20.4HU,分别)(p=0.009、0.002)。TLC的ROC-AUC值,TLMD,TLSD,TFWHM为0.91(95%置信区间[CI],0.828-0.936),0.66(95%CI,0.546-0.761),0.64(95%CI,0.524-0.742),和0.63(95%CI,0.511-0.731),分别。当TLC值为4110mL时,敏感性为90.7%(95%CI,79.7-96.9),特异性为77.8%(95%CI,57.7-91.4),准确性为86.4%.值得注意的是,TLC显示出最高的判别效率,F1得分为0.79,诊断赔率比为34.3,马修斯相关系数为0.69,超过TLMD(0.55,3.66,0.25),TLSD(0.56,3.95,0.26),和TFWHM(0.56,4.16,0.33)。
与非嗜酸性粒细胞性COPD患者相比,嗜酸性粒细胞性COPD患者的肺气肿水平较低,并且整个肺部的密度分布更均匀。此外,TLC显示出最高的诊断效率,并且可以作为区分两组的有价值的诊断标记。
UNASSIGNED: To investigate the characteristics and diagnostic performance of quantitative computed tomography (QCT) parameters in eosinophilic chronic obstructive pulmonary disease (COPD) patients.
UNASSIGNED: High-resolution CT scans of COPD patients were retrospectively analyzed, and various emphysematous parenchyma measurements, including lung volume (LC), lung mean density (LMD), lung standard deviation (LSD), full-width half maximum (FWHM), and lung relative voxel number (LRVN) were performed. The QCT parameters were compared between eosinophilic and noneosinophilic COPD patients, using a definition of eosinophilic COPD as blood eosinophil values ≥ 300 cells·µL-1 on at least three times. Receiver operating characteristic curves and area under the curve (ROC-AUC) and python were used to evaluate discriminative efficacy of QCT.
UNASSIGNED: Noneosinophilic COPD patients had a significantly lower TLMD (-846.3 ± 47.9 Hounsfield Unit [HU]) and TFWHM(162.5 ± 30.6 HU) compared to eosinophilic COPD patients (-817.8 ± 54.4, 177.3 ± 33.1 HU, respectively) (p = 0.018, 0.03, respectively). Moreover, the total LC (TLC) and TLSD were significantly lower in eosinophilic COPD group (3234.4 ± 1145.8, 183.8 ± 33.9 HU, respectively) than the noneosinophilic COPD group (5600.2 ± 1248.4, 203.5 ± 20.4 HU, respectively) (p = 0.009, 0.002, respectively). The ROC-AUC values for TLC, TLMD, TLSD, and TFWHM were 0.91 (95% confidence interval [CI], 0.828-0.936), 0.66 (95% CI, 0.546-0.761), 0.64 (95% CI, 0.524-0.742), and 0.63 (95% CI, 0.511-0.731), respectively. When the TLC value was 4110 mL, the sensitivity was 90.7% (95% CI, 79.7-96.9), specificity was 77.8% (95% CI, 57.7-91.4) and accuracy was 86.4%. Notably, TLC demonstrated the highest discriminative efficiency with an F1 Score of 0.79, diagnostic Odds Ratio of 34.3 and Matthews Correlation Coefficient of 0.69, surpassing TLMD (0.55, 3.66, 0.25), TLSD (0.56, 3.95, 0.26), and TFWHM (0.56, 4.16, 0.33).
UNASSIGNED: Eosinophilic COPD patients exhibit lower levels of emphysema and a more uniform density distribution throughout the lungs compared to noneosinophilic COPD patients. Furthermore, TLC demonstrated the highest diagnostic efficiency and may serve as a valuable diagnostic marker for distinguishing between the two groups.