Impact of different previous cancer history on the diagnostic efficiency of PNI-GARS and Lung-RADS

doi:10.3877/cma.j.issn.1674-6902.2024.06.013

Abstract

Abstract:

Objective

To investigate the effect of the length and source of malignancy history on the diagnostic efficacy of Lung-RADS （lung imaging-reporting and data system） 2022 and PNI-GARS （pulmonary node imaging-grading and reporting system） in pulmonary nodules （PNs）.

Methods

Chest computed tomography and clinical data of PNs in 451 patients with a history of cancer who underwent surgical resection in The First Affiliated Hospital of Chongqing Medical University from January，2018，to November，2021，were retrospectively collected and evaluated based on Lung-RADS and PNI-GARS，respectively.All PNs were divided into 2 groups：the prior lung cancer （PLC）144 cases and the prior extrapulmonary cancer （PEPC）groups 307cases.The diagnostic agreement rate（AR）of Lung-RADS and PNI-GARS was evaluated based on the pathological diagnosis of nodules after operation.The AR of the two systems and the composition ratios of PNs with different types between different groups were calculated and compared.

Results

A total of 451 patients with 565 PNs were included in this study.These patients were divided into the PLC group （＜5 years：135 cases，175 PNs； ≥5 years：9 cases，12 PNs） and the PEPC group （＜5 years：219 cases，278 PNs； ≥5 years：88 cases，100 PNs）.The diagnostic AR of Lung-RADS of partial solid nodules （93.0%） and solid nodules （88.1%） was close （P = 0.131），while both were higher than that of the ground-glass nodules（24.0%，all P values ＜0.001）.However，the diagnostic AR of PNI-GARS of partial solid nodules was the highest （100%，all P＜0.001），and the AR of solid nodules and ground glass nodules were similar with each other （88.5% vs. 84.8%， P=0.273）.Within 5 years，the composition ratio of PNs and the diagnostic AR of Lung-RADS （PLC：58.9%，PEPC：76.6%） between the PLC and PEPC groups were all different （all P values＜0.001），and the others （composition ratio of PNs & the diagnostic AR：PLC （≥5 years） vs. PEPC（≥5 years）； PLC （＜5 years） vs. PLC （≥5 years）； PEPC （＜5 years） vs. PEPC （≥5 years） were similar（all P values ＞0.05）.On the contrary，the diagnostic AR for PNI-GARS did not vary regardless of the length of previous cancer history or the type of previous malignancy.

Conclusion

The diagnostic efficiency of PNI-GARS would not be affected by the length of previous cancer history and the origin of previous malignancy，and the length of prior cancer history may impact the diagnostic performance of Lung-RADS.

Key words: Pulmonary nodule, Tomography，X-ray computed, Lung imaging-reporting and data system

Feipeng Song, Yingsheng Wang, Hongbo Xu, Fajin Lv. Impact of different previous cancer history on the diagnostic efficiency of PNI-GARS and Lung-RADS[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(06): 925-930.

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Figures/Tables 4

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系统	肺结节类别	一致	不一致	AR（%）	χ²	P值^d
Lung-RADS（n=565）	GGN（n=171）	41	130	24.0	178.086^a	0.000
	SN（n=252）	222	30	88.1	149.319^b	0.000
	PSN（n=142）	132	10	93.0	2.354^c	0.131
PNI-GARS（n=565）	GGN（n=171）	145	26	84.8	1.231^a	0.273
	SN（n=252）	223	29	88.5	23.547^b	0.000
	PSN（n=142）	142	0	100.0	17.640^c	0.000

系统	肺结节类别	一致	不一致	AR（%）	χ²	P值^d
Lung-RADS（n=565）	GGN（n=171）	41	130	24.0	178.086^a	0.000
	SN（n=252）	222	30	88.1	149.319^b	0.000
	PSN（n=142）	132	10	93.0	2.354^c	0.131
PNI-GARS（n=565）	GGN（n=171）	145	26	84.8	1.231^a	0.273
	SN（n=252）	223	29	88.5	23.547^b	0.000
	PSN（n=142）	142	0	100.0	17.640^c	0.000

病史	系统	项目	PLC	PEPC	χ²值	P值
＜5年		SN	52（29.7）	147（52.9）	-^a	0.331^e
		PSN	43（24.6）	65（23.4）	29.269^b	0.000^f
		GGN	80（45.7）	66（23.7）
		SN	6（50.0）	47（47.0）	2.722^c	0.321^g
≥5年		PSN	3（25.0）	31（31.0）	-^d	0.932^e
		GGN	3（25.0）	22（22.0）
＜5年	LR	一致	103（58.9）	213（76.6）	0.362^a	0.554^g
		不一致	72（41.1）	65（23.4）	16.060^b	0.000^g
＜5年	PG	一致	153（87.4）	25（91.4）	0^a	1.004^f
		不一致	22（12.6）	24（8.6）	1.826^b	0.121^f
≥5年	LR	一致	6（50.0）	73（73.0）	0.523^c	0.474^f
		不一致	6（50.0）	27（27.0）	2.727^d	0.102^f
≥5年	PG	一致	11（91.7）	92（92.0）	0.038^c	0.853^f
		不一致	1（8.3）	8（8.0）	-	1.004^e

病史	系统	项目	PLC	PEPC	χ²值	P值
＜5年		SN	52（29.7）	147（52.9）	-^a	0.331^e
		PSN	43（24.6）	65（23.4）	29.269^b	0.000^f
		GGN	80（45.7）	66（23.7）
		SN	6（50.0）	47（47.0）	2.722^c	0.321^g
≥5年		PSN	3（25.0）	31（31.0）	-^d	0.932^e
		GGN	3（25.0）	22（22.0）
＜5年	LR	一致	103（58.9）	213（76.6）	0.362^a	0.554^g
		不一致	72（41.1）	65（23.4）	16.060^b	0.000^g
＜5年	PG	一致	153（87.4）	25（91.4）	0^a	1.004^f
		不一致	22（12.6）	24（8.6）	1.826^b	0.121^f
≥5年	LR	一致	6（50.0）	73（73.0）	0.523^c	0.474^f
		不一致	6（50.0）	27（27.0）	2.727^d	0.102^f
≥5年	PG	一致	11（91.7）	92（92.0）	0.038^c	0.853^f
		不一致	1（8.3）	8（8.0）	-	1.004^e

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