Impact Of Prognostic Of Visceral Pleural Invasion And Vessel Invasion In Surgivally Resected Non-Small-Cell Lung Cancer

Objective:Visceral pleural invasion (VPI) and vessel invasion (VI) are poor prognostic factor of patients with non-small cell lung cancer. The purpose of this study was to validate the prognostic impact of VPI and VI on survival outcomes for non-small-cell lung carcinoma(NSCLC).preliminary assessment of VPI and VI associated with the relationship between the CT imaging performance was studied.Methods:A total of 210 patients who underwent lobectomy and diagnosed with NSCLC between January 2007 and December 2013 were retrospectively analyzed. Visceral pleural invasion(VPI) was identified in 51 patients as a VPI group, the other 159 patients without VPI were as a non-VPI group. Vessel invasion(VI) was identified in 29 patients as a VI group, the other 181 patients without VI were as a non-VI group. Clinical characteristics, overall survival(OS),disease-free survival(DFS) were in compared.100 cases with complete CT imaging data were Selected, the correlation analysis of VPI and VI with the corresponding imaging performance were carried out.Results:The 1-year,3-year and 5-year OS rate in VPI group were lower than those in non-VPI group(88.2%,56.7% and 52.7% vs 96.7%,80.1% and 68.3%) (P=0.004). The 1-year,3-year and 5-year OS rate in VI group were lower than those in non-â…¥ group(79.3%,56.8% and 48.7% vs 96.7%,77.2% and 66.5%) (P=0.011). Cox regression showed lymph node metastasis,tumor size, VPI and VI were significant prognostic factors for the patients with NSCLC. Univariate analysis of imaging findings showed that VPI was associated with the tumor abut the pleura (P<0.05). There were no significant correlations between pleural indentation, spiculation and VPI or â…¥(P>0.05). ROC analysis showed that the accuracy, sensitivity, specific of the largest diameter of tumor, tumor-wall minimum distance to diagnose VPI was 70.00%.80.65%,53.03% å'Œ63.20%,58.06%,73.13%.The accuracy, sensitivity, specific of CT HU, mediastinal/lung window maximum diameter ratio to diagnose VI was 55.00%,75.00%,39.29%å'Œ60.00%,87.50%,45.24%.Conclusion:1.The patients with VPI or VI may need more postoperative therapy because of their poorprognostic.2.No significant relationship between pleural indentation and VPI, or between spiculation and VI.VPI may be connected with the tumor abut the pleura.3.The correlation analysis of VPI and VI with the corresponding imaging performance that included the largest diameter of tumor, tumor-wall minimum distance, CT HU, mediastinal/lung window maximum diameter ratio has few clinical value.