Association between the number and size of intrapulmonary lymph nodes and chronic obstructive pulmonary disease severity

PeerJ

article

Anton Schreuder¹  Colin Jacobs¹  Ernst T. Scholten¹  Mathias Prokop¹  Bram van Ginneken¹  David A. Lynch³  Cornelia M. Schaefer-Prokop¹ 

[1] Department of Radiology and Nuclear Medicine;Fraunhofer MEVIS;Department of Radiology, National Jewish Medical and Research Center;Department of Radiology

关键词: Chronic obstructive pulmonary disease;    Lymph node;    Pulmonary nodule;    Prevalence;    Observer variation;    Computed tomography;    Perifissural nodule;   

DOI  :  10.7717/peerj.9166

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

PurposeOne of the main pathophysiological mechanisms of chronic obstructive pulmonary disease is inflammation, which has been associated with lymphadenopathy. Intrapulmonary lymph nodes can be identified on CT as perifissural nodules (PFN). We investigated the association between the number and size of PFNs and measures of COPD severity.Materials and MethodsCT images were obtained from COPDGene. 50 subjects were randomly selected per GOLD stage (0 to 4), GOLD-unclassified, and never-smoker groups and allocated to either “Healthy,” “Mild,” or “Moderate/severe” groups. 26/350 (7.4%) subjects had missing images and were excluded. Supported by computer-aided detection, a trained researcher prelocated non-calcified opacities larger than 3 mm in diameter. Included lung opacities were classified independently by two radiologists as either “PFN,” “not a PFN,” “calcified,” or “not a nodule”; disagreements were arbitrated by a third radiologist. Ordinal logistic regression was performed as the main statistical test.ResultsA total of 592 opacities were included in the observer study. A total of 163/592 classifications (27.5%) required arbitration. A total of 17/592 opacities (2.9%) were excluded from the analysis because they were not considered nodular, were calcified, or all three radiologists disagreed. A total of 366/575 accepted nodules (63.7%) were considered PFNs. A maximum of 10 PFNs were found in one image; 154/324 (47.5%) contained no PFNs. The number of PFNs per subject did not differ between COPD severity groups (p = 0.50). PFN short-axis diameter could significantly distinguish between the Mild and Moderate/severe groups, but not between the Healthy and Mild groups (p = 0.021).ConclusionsThere is no relationship between PFN count and COPD severity. There may be a weak trend of larger intrapulmonary lymph nodes among patients with more advanced stages of COPD.

【 授权许可】

CC BY