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Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study
OBJECTIVE: To establish a preoperative model for the differential diagnosis of benign and malignant pulmonary nodules (PNs), and to evaluate the related factors of overdiagnosis of benign PNs at the time of imaging assessments. MATERIALS AND METHODS: In this retrospective study, 357 patients (median...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664309/ https://www.ncbi.nlm.nih.gov/pubmed/37990211 http://dx.doi.org/10.1186/s12890-023-02727-7 |
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author | Duan, Xirui Ouyang, Zhiqiang Bao, Shasha Yang, Lu Deng, Ailin Zheng, Guangrong Zhu, Yu Li, Guochen Chu, Jixiang Liao, Chengde |
author_facet | Duan, Xirui Ouyang, Zhiqiang Bao, Shasha Yang, Lu Deng, Ailin Zheng, Guangrong Zhu, Yu Li, Guochen Chu, Jixiang Liao, Chengde |
author_sort | Duan, Xirui |
collection | PubMed |
description | OBJECTIVE: To establish a preoperative model for the differential diagnosis of benign and malignant pulmonary nodules (PNs), and to evaluate the related factors of overdiagnosis of benign PNs at the time of imaging assessments. MATERIALS AND METHODS: In this retrospective study, 357 patients (median age, 52 years; interquartile range, 46–59 years) with 407 PNs were included, who underwent surgical histopathologic evaluation between January 2020 and December 2020. Patients were divided into a training set (n = 285) and a validation set (n = 122) to develop a preoperative model to identify benign PNs. CT scan features were reviewed by two chest radiologists, and imaging findings were categorized. The overdiagnosis rate of benign PNs was calculated, and bivariate and multivariable logistic regression analyses were used to evaluate factors associated with benign PNs that were over-diagnosed as malignant PNs. RESULTS: The preoperative model identified features such as the absence of part-solid and non-solid nodules, absence of spiculation, absence of vascular convergence, larger lesion size, and CYFRA21-1 positivity as features for identifying benign PNs on imaging, with a high area under the receiver operating characteristic curve of 0.88 in the validation set. The overdiagnosis rate of benign PNs was found to be 50%. Independent risk factors for overdiagnosis included diagnosis as non-solid nodules, pleural retraction, vascular convergence, and larger lesion size at imaging. CONCLUSION: We developed a preoperative model for identifying benign and malignant PNs and evaluating factors that led to the overdiagnosis of benign PNs. This preoperative model and result may help clinicians and imaging physicians reduce unnecessary surgery. |
format | Online Article Text |
id | pubmed-10664309 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106643092023-11-21 Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study Duan, Xirui Ouyang, Zhiqiang Bao, Shasha Yang, Lu Deng, Ailin Zheng, Guangrong Zhu, Yu Li, Guochen Chu, Jixiang Liao, Chengde BMC Pulm Med Research OBJECTIVE: To establish a preoperative model for the differential diagnosis of benign and malignant pulmonary nodules (PNs), and to evaluate the related factors of overdiagnosis of benign PNs at the time of imaging assessments. MATERIALS AND METHODS: In this retrospective study, 357 patients (median age, 52 years; interquartile range, 46–59 years) with 407 PNs were included, who underwent surgical histopathologic evaluation between January 2020 and December 2020. Patients were divided into a training set (n = 285) and a validation set (n = 122) to develop a preoperative model to identify benign PNs. CT scan features were reviewed by two chest radiologists, and imaging findings were categorized. The overdiagnosis rate of benign PNs was calculated, and bivariate and multivariable logistic regression analyses were used to evaluate factors associated with benign PNs that were over-diagnosed as malignant PNs. RESULTS: The preoperative model identified features such as the absence of part-solid and non-solid nodules, absence of spiculation, absence of vascular convergence, larger lesion size, and CYFRA21-1 positivity as features for identifying benign PNs on imaging, with a high area under the receiver operating characteristic curve of 0.88 in the validation set. The overdiagnosis rate of benign PNs was found to be 50%. Independent risk factors for overdiagnosis included diagnosis as non-solid nodules, pleural retraction, vascular convergence, and larger lesion size at imaging. CONCLUSION: We developed a preoperative model for identifying benign and malignant PNs and evaluating factors that led to the overdiagnosis of benign PNs. This preoperative model and result may help clinicians and imaging physicians reduce unnecessary surgery. BioMed Central 2023-11-21 /pmc/articles/PMC10664309/ /pubmed/37990211 http://dx.doi.org/10.1186/s12890-023-02727-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Duan, Xirui Ouyang, Zhiqiang Bao, Shasha Yang, Lu Deng, Ailin Zheng, Guangrong Zhu, Yu Li, Guochen Chu, Jixiang Liao, Chengde Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title | Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title_full | Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title_fullStr | Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title_full_unstemmed | Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title_short | Factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
title_sort | factors associated with overdiagnosis of benign pulmonary nodules as malignancy: a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10664309/ https://www.ncbi.nlm.nih.gov/pubmed/37990211 http://dx.doi.org/10.1186/s12890-023-02727-7 |
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