Clinical and CT Features of Peripheral Lung Sarcomatoid Carcinoma Versus Solitary Pneumonic Lesions and Non-Small Cell Lung Cancer:A Comparative Study
10.3969/j.issn.1005-5185.2025.01.007
- VernacularTitle:周围型肺肉瘤样癌与孤立性肺炎性病变及非小细胞肺癌的临床及CT特征对照
- Author:
Peiling ZOU
1
;
Qi LI
;
Xin FAN
;
Yue ZHANG
Author Information
1. 重庆医科大学附属第一医院放射科,重庆 400016;重庆大学附属沙坪坝医院放射科,重庆 400030
- Publication Type:Journal Article
- Keywords:
Lung sarcomatoid carcinoma;
Carcinosarcoma;
Pneumonia lesion;
Carcinoma,non-small-cell lung;
Tomography,X-ray computed;
Diagnosis,differential
- From:
Chinese Journal of Medical Imaging
2025;33(1):41-47
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the differences of clinical and CT features between peripheral lung sarcomatoid carcinoma(PLSC),solitary pulmonary lesion(SPL),and common non-small cell lung cancer(CNSCLC),and to improve the diagnostic accuracy of PLSC.Materials and Methods Thirty patients with pathologically confirmed PLSC(sarcomatoid carcinoma group)were enrolled,and 68 cases of SPL(pneumonia group)and 73 cases of CNSCLC(lung cancer group)were selected as the control group,the clinical and CT features of PLSC were compared with SPL and NSCLC,respectively.A binary Logistic regression model was constructed based on the above statistically different parameters,and the area under the curve was used to evaluate the diagnostic efficiency of the regression model.Results Compared with clinical features,the proportion of smokers in sarcomatoid carcinoma group was significantly higher than that in pneumonia group and lung cancer group.The proportion of patients with a family history of first-degree relative malignancy in the sarcomatoid carcinoma group was significantly higher than that in the pneumonia group.The incidence of respiratory symptoms in sarcomatoid carcinoma group was significantly higher than that in lung cancer group(x2=5.800-16.611,all P＜0.025).Compared with CT features,the incidence of extensive necrosis and circular enhancement in PLSC group were significantly higher than those in SPL and CNSCLC group,while ΔCT value of both arterial and venous phase in PLSC group were significantly lower than those in the other two groups.The incidence of lobulation and air bronchogram of PLSC group were significantly higher than those of SPL group,but the incidence of pleural attachment and linear enhancement around the necrotic area of PLSC group were significantly lower than that of SPL group.The longest diameter of lesion in PLSC group was significantly larger than that in lung CNSCLC group,and the incidence of necrosis was significantly higher than that CNSCLC cancer group(x2/Z=-5.784-31.877,all P＜0.025).Compared with SPL,family history of malignancy,presence of air bronchogram and circular enhancement,absence of pleural attachment,and lower ΔCT value of venous phase were independent predictors of PLSC.The area under the curve of this model was 0.975.Compared with CNSCLC,the presence of respiratory symptoms,larger lesion,and circular enhancement were independent predictors of PLSC,and the area under the curve of this model was 0.870.Conclusion The clinical and CT features of PLSC are significantly different from those of SPL and CNSCLC.Identifying these differences correctly can help improve the preoperative diagnostic accuracy and the prognosis of patients.
