Cryptococcosis, Lung Adenocarcinoma
Conditions
Brief summary
Pulmonary cryptococcosis often manifests as isolated or multiple nodules, easily mimicking lung cancer clinically and radiologically, which ascribes the poor sensitivity of Cryptococcus culture and rarely positive of Cryptococcal antigen test in the absence of disseminated disease. Therefore, the aim of this study was to develop a predictive scoring system from the perspective of available clinical indicators, to differentiate cryptococcosis from adenocarcinoma in pulmonary nodules, which might be beneficial for the delicacy management of pulmonary nodules.
Detailed description
Nodule is generally defined as a small, approximately spherical in morphology, circumscribed focus of abnormal tissue on computed tomography (CT) and no greater than 3cm in maximum diameter. Pulmonary nodules are not uncommon. A systematic review of CT screening lung cancer trials noted that a lung nodule was detected in up to 51% of study participants. More than 95% of detected nodules are benign and have a wide variety of causes, including infections, granulomatous disease, hamartomas, arteriovenous malformations, round atelectasis, and lymph nodes. Pulmonary cryptococcosis is caused by Cryptococcus spp., a ubiquitous budding yeast-like basidiomycete that is endemic in many countries. Previously, Pulmonary cryptococcosis was thought to be an important opportunistic invasive mycosis in immunocompromised patients, such as AIDS, immunosuppressor used after organ transplantation, but it is also common in immunocompetent patients. Pulmonary cryptococcosis often manifests as isolated or multiple nodules, easily mimicking lung cancer clinically and radiologically, which ascribes the poor sensitivity of Cryptococcus culture and rarely positive of Cryptococcal antigen test in the absence of disseminated disease. Therefore, the aim of this multicenter observational study was to develop a predictive scoring system from the perspective of available clinical indicators, to differentiate cryptococcosis from adenocarcinoma in pulmonary nodules, which might be beneficial for the delicacy management of pulmonary nodules.
Interventions
DIAGNOSTIC_TESTA scoring system
The scoring system was used to rate score patients.
Sponsors
Shanghai Pulmonary Hospital, Shanghai, China
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Inclusion criteria
* Patients with pulmonary nodules * Evidence of pathological diagnosis for cryptococcosis or adenocarcinoma * Data on high-resolution computed tomography (HRCT)
Exclusion criteria
* Pulmonary nodules greater than 3cm in maximum diameter * Lack of data on HRCT
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Area under receiver operating characteristic curve | up to 24 weeks | Area under Receiver Operating Characteristic (ROC) curve was used to identify the diagnostic value of the scoring system. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of the scoring system | up to 24 weeks | Sensitivity of the scoring system was used to assess the true positive rate of pulmonary cryptococcosis |
| Specificity of the scoring system | up to 24 weeks | Specificity of the scoring system was used to assess the true negative rate of pulmonary cryptococcosis |
Countries
China
Contacts
Primary ContactJin-fu Xu, MD
Outcome results
None listed