Risk analysis of visceral pleural invasion in malignant solitary pulmonary nodules that appear touching the pleural surface

The preoperative determination of visceral pleural invasion (VPI) in patients with malignant solitary pulmonary nodules (SPNs) is essential for determining the surgical range and selecting adjuvant chemotherapy. This study aimed to systematically investigate risk factors of VPI in patients with SPN...

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Bibliographic Details
Published in:Therapeutic advances in respiratory disease 2024-01, Vol.18, p.17534666241285606
Main Authors: Zhu, Ziwen, Jiang, Weizhen, Zhou, Danhong, Zhu, Weidong, Chen, Cheng
Format: Article
Language:English
Subjects:
Adult
Aged
Clinical Decision-Making
Decision Support Techniques
Female
Humans
Lung Neoplasms - pathology
Male
Middle Aged
Neoplasm Invasiveness
Nomograms
Original Research
Pleura - diagnostic imaging
Pleura - pathology
Predictive Value of Tests
Retrospective Studies
Risk Assessment
Risk Factors
Solitary Pulmonary Nodule - diagnostic imaging
Solitary Pulmonary Nodule - pathology
Solitary Pulmonary Nodule - surgery
Tomography, X-Ray Computed
Tumor Burden
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Summary:The preoperative determination of visceral pleural invasion (VPI) in patients with malignant solitary pulmonary nodules (SPNs) is essential for determining the surgical range and selecting adjuvant chemotherapy. This study aimed to systematically investigate risk factors of VPI in patients with SPN and construct a preoperative predictive model for such patients. This is a retrospective study. The clinical, radiological, and pathological characteristics of study subjects were reviewed, and the groups with and without VPI were compared. Multivariate logistic analysis was utilized to identify independent risk factors for VPI. Moreover, a predictive nomogram was constructed to assess the likelihood of VPI occurrence. Of the 364 enrolled cases, SPNs adjacent to the pleura with VPI were found in 110 (30.2%) patients. By incorporating four preoperative variables, including tumor diameter (>2 cm), maximum computed tomography value (>200 Hu), air bronchogram sign, and age, a preoperative predictive nomogram was constructed. The nomogram demonstrated good discriminative ability, with a C-index of 0.736 (95% CI (0.662-0.790)). Furthermore, our data indicated that the air bronchogram sign (odd ratio (OR) 1.81, 95% CI (0.99-3.89),  = 0.048), a maximum diameter >2 cm (OR 24.48, 95% CI (8.43-71.07),  
ISSN:1753-4666
1753-4658
1753-4666
DOI:10.1177/17534666241285606