在患有食道癌的患者中,间歇性肺异常和死亡率之间的关联
Akinori Hata1, Masahiro Yanagawa2, Tomo Miyata3
1Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 5650871, Japan. a-hata@radiol.med.osaka-u.ac.jp.
Japanese journal of radiology
|April 24, 2024
概括
间歇性肺异常 (ILAs) 与食道癌患者的生存率降低有关. ILA增加了死于肺炎和呼吸衰竭的风险,而不是直接死于癌症.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 食道癌带来了显著的死亡风险.
- 间歇性肺异常 (ILA) 越来越多地被认为是一种并发症.
- ILAs对食道癌患者结局的影响仍在调查中.
研究的目的:
- 在被诊断患有食道癌的患者中,检查间歇性肺异常 (ILA) 与整体存活率 (OS) 之间的关联.
- 确定ILA是否影响该患者队列中的死亡原因.
- 分析特定的ILA子类别及其预后价值.
主要方法:
- 对478名食道癌患者 (2011-2015年) 的回顾性分析.
- 在基线CT扫描中使用3分尺度对ILAs的视觉评分.
- 多变量Cox比例危险模型评估了OS;费舍尔的精确测试分析了死亡原因.
主要成果:
- 与没有 (n=267) (HR=1.68,P=0.016) 的患者相比,具有ILAs (n=86) 的患者的生存寿命显著较短 (HR=1.68,P=0.016).
- 脑下纤维性ILA与降低的存活率 (HR=2.22,P=0.006) 有着强烈的关联.
- ILA与肺炎/呼吸衰竭 (13%对2%,P=0.022) 的死亡率较高有关,但与食道癌本身无关.
结论:
- 间歇性肺异常是食道癌患者整体生存期的独立负面预后因素.
- 与ILA相关的死亡风险增加似乎主要是由呼吸道并发症驱动的.
- 激光识别ILA可能有助于风险分层和患者管理.
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