Cargando…

Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response

PURPOSE: The proportion of central pulmonary adenocarcinoma (ADC) in central-type lung cancer has been gradually increasing due to the overall increasing incidence of pulmonary ADC. But the clinical and radiological characteristics of central ADCs remain unclear. In this study, we compared the clini...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Zhe, Li, Minghuan, Huang, Yong, Ma, Li, Zhu, Hui, Kong, Li, Yu, Jinming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942174/
https://www.ncbi.nlm.nih.gov/pubmed/29765230
http://dx.doi.org/10.2147/OTT.S154385
_version_ 1783321426688737280
author Wang, Zhe
Li, Minghuan
Huang, Yong
Ma, Li
Zhu, Hui
Kong, Li
Yu, Jinming
author_facet Wang, Zhe
Li, Minghuan
Huang, Yong
Ma, Li
Zhu, Hui
Kong, Li
Yu, Jinming
author_sort Wang, Zhe
collection PubMed
description PURPOSE: The proportion of central pulmonary adenocarcinoma (ADC) in central-type lung cancer has been gradually increasing due to the overall increasing incidence of pulmonary ADC. But the clinical and radiological characteristics of central ADCs remain unclear. In this study, we compared the clinical and radiological characteristics of central ADCs with those of small cell lung cancers (SCLCs) and squamous cell carcinomas (SQCCs) and investigated the impact of these characteristics on patients’ treatment response. PATIENTS AND METHODS: The medical records of 302 consecutive patients with central lung cancer from July 2014 to September 2016 were retrospectively reviewed. There were 99 patients with ADC, 95 with SQCC and 108 with SCLC. Computed tomography images were interpreted by two radiologists. Treatment response was determined by Response Evaluation Criteria In Solid Tumors 1.1. RESULTS: Univariate analyses found that younger age, female sex, no history of smoking, higher levels of carcinoembryonic antigen (CEA), contralateral hilum lymphadenopathy, contralateral lung metastasis, pleural nodules and pleural metastasis to the interlobular fissure were significantly correlated with central ADC. Multivariate logistic regression analyses revealed that compared with central SQCC, female sex, younger age, no history of smoking, higher levels of CEA and contralateral hilum lymphadenopathy were the significantly independent indicators of central pulmonary ADC. Furthermore, compared with central SCLC, younger age, higher levels of CEA and cytokeratin 19 fragment (Cyfra21-1), lower levels of neuron-specific enolase, pleural nodules and lack of vascular involvement were significantly associated with central ADC. In 85 central ADC patients who received first-line platinum-based chemotherapy, both univariate and multivariate logistic regression analyses revealed that pulmonary emphysema had a negative correlation with treatment response (odds ratio=8.04, p=0.02). CONCLUSION: Our study revealed that central pulmonary ADCs exhibited more aggressive clinical and radiological characteristics. Pulmonary emphysema was an independent and negative indicator for treatment response of central ADC.
format Online
Article
Text
id pubmed-5942174
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-59421742018-05-14 Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response Wang, Zhe Li, Minghuan Huang, Yong Ma, Li Zhu, Hui Kong, Li Yu, Jinming Onco Targets Ther Original Research PURPOSE: The proportion of central pulmonary adenocarcinoma (ADC) in central-type lung cancer has been gradually increasing due to the overall increasing incidence of pulmonary ADC. But the clinical and radiological characteristics of central ADCs remain unclear. In this study, we compared the clinical and radiological characteristics of central ADCs with those of small cell lung cancers (SCLCs) and squamous cell carcinomas (SQCCs) and investigated the impact of these characteristics on patients’ treatment response. PATIENTS AND METHODS: The medical records of 302 consecutive patients with central lung cancer from July 2014 to September 2016 were retrospectively reviewed. There were 99 patients with ADC, 95 with SQCC and 108 with SCLC. Computed tomography images were interpreted by two radiologists. Treatment response was determined by Response Evaluation Criteria In Solid Tumors 1.1. RESULTS: Univariate analyses found that younger age, female sex, no history of smoking, higher levels of carcinoembryonic antigen (CEA), contralateral hilum lymphadenopathy, contralateral lung metastasis, pleural nodules and pleural metastasis to the interlobular fissure were significantly correlated with central ADC. Multivariate logistic regression analyses revealed that compared with central SQCC, female sex, younger age, no history of smoking, higher levels of CEA and contralateral hilum lymphadenopathy were the significantly independent indicators of central pulmonary ADC. Furthermore, compared with central SCLC, younger age, higher levels of CEA and cytokeratin 19 fragment (Cyfra21-1), lower levels of neuron-specific enolase, pleural nodules and lack of vascular involvement were significantly associated with central ADC. In 85 central ADC patients who received first-line platinum-based chemotherapy, both univariate and multivariate logistic regression analyses revealed that pulmonary emphysema had a negative correlation with treatment response (odds ratio=8.04, p=0.02). CONCLUSION: Our study revealed that central pulmonary ADCs exhibited more aggressive clinical and radiological characteristics. Pulmonary emphysema was an independent and negative indicator for treatment response of central ADC. Dove Medical Press 2018-05-04 /pmc/articles/PMC5942174/ /pubmed/29765230 http://dx.doi.org/10.2147/OTT.S154385 Text en © 2018 Wang et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Wang, Zhe
Li, Minghuan
Huang, Yong
Ma, Li
Zhu, Hui
Kong, Li
Yu, Jinming
Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title_full Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title_fullStr Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title_full_unstemmed Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title_short Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
title_sort clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942174/
https://www.ncbi.nlm.nih.gov/pubmed/29765230
http://dx.doi.org/10.2147/OTT.S154385
work_keys_str_mv AT wangzhe clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT liminghuan clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT huangyong clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT mali clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT zhuhui clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT kongli clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse
AT yujinming clinicalandradiologicalcharacteristicsofcentralpulmonaryadenocarcinomaacomparisonwithcentralsquamouscellcarcinomaandsmallcelllungcancerandtheimpactontreatmentresponse