癌手术后的肺病变:进展还是新的原发性?
Daniele Cignoli1, Alessandro Bandiera2, Giuseppe Rosiello3
1Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. cignoli.daniele@hsr.it.
World journal of urology
|May 30, 2024
概括
在以前为细胞癌 (RCC) 接受治疗的患者中,区分肺癌和癌转移至关重要. 吸烟史和RCC特征有助于区分这些疾病,影响患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
背景情况:
- 在有细胞癌 (RCC) 病史的患者中,区分新发原发性肺癌 (LC) 和癌转移 (RCCM+) 在临床上具有意义.
- 在手术治疗RCC患者的随访期间检测到的肺部质量需要仔细评估以确定其来源.
研究的目的:
- 在接受RCC治疗的患者中,调查细胞癌 (RCCM+) 和元慢性肺癌 (LC) 引起的肺转移之间的临床和放射学差异.
- 为了确定区分LC和RCCM+之间的预测因素.
主要方法:
- 在随访期间对cM0手术治疗的RCC患者进行了回顾性分析.
- 单变量和多变量逻辑回归分析以确定预测特征.
- 生存分析,以评估诊断对患者结果的影响.
主要成果:
- 87%的肺部质量是RCCM+,13%是LC.
- 慢性结核与吸烟史和较少攻击性的RCC特征有关,而RCCM+显示多个和双边结核.
- 预测LC的预测因素包括吸烟史和RCC手术和肺质量检测之间的较长间隔;RCCM+的预测因素包括初级RCC特征和结节数量/双边性.
结论:
- 吸烟史,原发性RCC等级和阶段,RCC手术和肺部质量检测之间的间隔,以及肺病变数量是区分新发原发性肺癌和RCC进展的关键预测因素.
- 准确的差异化影响预后评估和治疗策略.
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