[Influence of computed tomography of the abdomen for staging lung cancer].
OBJECTIVE
To analyze the influence of routine imaging of the upper abdomen by conventional computed tomography (CT) to stage bronchopulmonary carcinoma and to detect liver or adrenal metastasis. A second objective was to describe the characteristics of a large group of patients in our practice.


METHODS
Retrospective study of 387 patients (367 men and 20 women; mean age [+/-SD] 62.3 +/- 10.4 years, range 34-90 years) who had received a diagnosis of lung cancer (203 epidermoid carcinoma, 75 adenocarcinoma, 15 non-small cell carcinoma, 68 small cell carcinoma and 25 mixed tumors). CT images were obtained of the chest and upper abdomen with intravenous contrast except in patients with a history of allergy or renal insufficiency. The characteristics associated with abdominal CT images aiding or confusing diagnosis were analyzed by Spearman coefficient. Differences related to sex or histology were studied using a Mann-Whitney U-test and Kruskal-Wallis test.


RESULTS
The upper abdominal CT changed the staging of 27 patients (7%): non-small cell carcinoma 5% (16/319) and small-cell carcinoma 16.2% (11/68). Twelve patients (3.1%) showed evidence of unconfirmed adrenal or hepatic metastasis. Change of staging after CT was associated with a high creatinine concentration in blood (p = 0.032), whereas confusion of diagnosis after CT was more common for women (p = 0.002) and patients for whom the diagnosis was established by cytology of sputum or bronchial aspirate (p = 0.019). Differences between men and women were found for from pathology (p = 0.027), confusion after CT (p = 0.002), hemoglobin (p = 0.011), hematocrit (p = 0.019) and smoking (p = 0.000).


CONCLUSIONS
Given the considerable limitations of CT imaging of the upper abdomen, new technologies should be developed to facilitate a more rational approach to the problem.
Maya Martínez
M
M
Servicios de Neumología. Hospital Clínico Universitario de Valencia. Universitat de València.
Carrión Valero
F
F
Díaz López
J
J
Mollá Landete
M A
MA
Marín Pardo
J
J
D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000000981:diagnostic imaging; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000000981:diagnostic imaging; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000000981:diagnostic imaging; D004796:Clinical Enzyme Tests; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed