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Computed tomography versus frozen sections for distinguishing lung adenocarcinoma: A cohort study of concordance rate.
Lv, Yi-Lv; Zhang, Jing; Xu, Kuan; Jin, Xiao-Yan; Zhang, Xiao-Bing; Yang, Huan-Huan; Fan, Xing-Hai; Zhang, Ya-Juan; Li, Min; Zheng, Zhi-Chun; Huang, Jia; Ye, Xiao-Dan; Tao, Guang-Yu; Han, Yu-Chen; Ye, Bo.
Afiliación
  • Lv YL; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Zhang J; Department of Pulmonary and Critical Care Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
  • Xu K; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Jin XY; Department of Pulmonary and Critical Care Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China.
  • Zhang XB; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Yang HH; Department of Respiratory Medicine, Shanghai Zhongye Hospital, Shanghai, 200941, China.
  • Fan XH; Department of Respiratory Medicine, Shanghai Zhongye Hospital, Shanghai, 200941, China.
  • Zhang YJ; Department of Respiratory Medicine, Central Hospital of Minhang District, Shanghai, Shanghai Jiao Tong University, Shanghai, 201100, China.
  • Li M; Department of Radiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China.
  • Zheng ZC; Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Huang J; Department of Oncology Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Ye XD; Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Tao GY; Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Han YC; Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.
  • Ye B; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China. Electronic address: yb1373@shchest.org.
Asian J Surg ; 45(11): 2172-2178, 2022 Nov.
Article en En | MEDLINE | ID: mdl-35346584
ABSTRACT

BACKGROUND:

Computed tomography (CT) imaging can help to predict the pathological invasiveness of early-stage lung adenocarcinoma and guide surgical resection. This retrospective study investigated whether CT imaging could distinguish pre-invasive lung adenocarcinoma from IAC. It also compared final pathology prediction accuracy between CT imaging and intraoperative frozen section analysis.

METHODS:

This study included 2093 patients with early-stage peripheral lung adenocarcinoma who underwent CT imaging and intraoperative frozen section analysis between March 2013 and November 2014. Nodules were classified as ground-glass (GGNs), part-solid (PSNs), and solid nodules according to CT findings; they were classified as pre-IAC and IAC according to final pathology. Univariate, multivariate, and receiver operating characteristic (ROC) curve analyses were performed to evaluate whether CT imaging could distinguish pre-IAC from IAC. The concordance rates of CT imaging and intraoperative frozen section analyses with final pathology were also compared to determine their accuracies.

RESULTS:

Multivariate analysis identified tumor size as an independent distinguishing factor. ROC curve analyses showed that the optimal cut-off sizes for distinguishing pre-IAC from IAC for GGNs, PSNs, and solid nodules were 10.79, 11.48, and 11.45 mm, respectively. The concordance rate of CT imaging with final pathology was significantly greater than the concordance rate of intraoperative frozen section analysis with final pathology (P = 0.041).

CONCLUSION:

CT imaging could distinguish pre-IAC from IAC in patients with early-stage lung adenocarcinoma. Because of its accuracy in predicting final pathology, CT imaging could contribute to decisions associated with surgical extent. Multicenter standardized trials are needed to confirm the findings in this study.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adenocarcinoma / Adenocarcinoma del Pulmón / Neoplasias Pulmonares Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Asian J Surg Año: 2022 Tipo del documento: Article País de afiliación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Adenocarcinoma / Adenocarcinoma del Pulmón / Neoplasias Pulmonares Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Asian J Surg Año: 2022 Tipo del documento: Article País de afiliación: China