Background
For thoracic surgeons, three-dimensional computed tomography bronchography and angiography (3-DCTBA) is a convenient way to analyze pulmonary variations before segmentectomy. Mediastinal lingular artery (MLA) is one of the representative variations.
Methods
The 3-DCTBA data of left upper lobe (LUL) were collected from patients who underwent pulmonary surgery from January 2018 to December 2019. We reviewed the patterns of bronchi and pulmonary vessels and grouped them according to different classifications.
Results
Among all the 404 cases of 3-DCTBA, mediastinal lingular artery (MLA) was found in 107 cases (26.49%). The patterns of B3 and the vein in left upper division (LUD) are distinct between mediastinal (M-type) group and interlobar (IL-type) group. The patterns of bronchi and veins in lingular division, as well as the pattern of pulmonary artery in LUD, have no differences between M-type and IL-type groups.
Conclusions
Mediastinal lingular artery is speculated to originate from the variation of B3, and the MLA independently influences the venous pattern in LUD in turn.
Background
Tumor size and consolidation‐to‐tumor ratio (CTR) are crucial for non–small cell lung cancer (NSCLC) prognosis. However, the optimal CTR cutoff remains unclear. Whether tumor size and CTR are independent prognostic factors for part‐solid NSCLC is under debate. Here, we aimed to evaluate the prognostic impacts of CTR and tumor size on NSCLC, especially on part‐solid NSCLC.
Methods
We reviewed 1366 clinical T1 NSCLC patients who underwent surgical treatment. Log‐rank test and Cox regression analyses were adopted for prognostic evaluation. The “surv_cutpoint” function was used to identify the optimal CTR and tumor size cutoff values.
Results
There were 416, 510, and 440 subjects with pure ground‐glass opacity (pGGO), part‐solid, and pure solid nodules. The 5‐year overall survival (disease‐free survival) for patients with pGGO, part‐solid, and pure solid nodules were 99.5% (99.5%), 97.3% (95.8%), and 90.4% (78.9%), respectively. Multivariate Cox regression analysis indicated that CTR was an independent prognostic factor for the whole patients, and the optimal CTR cutoff was 0.99. However, for part‐solid NSCLC, CTR was not independently associated with survival, even if categorized by the optimal cutoffs. The predicted optimal cutoffs of total tumor size and solid component size were 2.4 and 1.4 cm for part‐solid NSCLC. Total tumor size (HR = 6.21, 95% CI: 1.58–24.34,
p
= 0.009) and solid component size (HR = 2.27, 95% CI: 1.04–5.92,
p
= 0.045) grouped by the cutoffs were significantly associated with part‐solid NSCLC prognosis.
Conclusions
CTR was an independent prognostic factor for the whole NSCLC, but not for the part‐solid NSCLC. Tumor size was still meaningful for part‐solid NSCLC.
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