PMID- 24139213
OWN - NLM
STAT- MEDLINE
DCOM- 20140204
LR  - 20131210
IS  - 1532-8392 (Electronic)
IS  - 0046-8177 (Linking)
VI  - 45
IP  - 1
DP  - 2014 Jan
TI  - Development of a multivariate model to predict the likelihood of carcinoma in 
      patients with indeterminate peripheral lung nodules after a nondiagnostic 
      bronchoscopic evaluation.
PG  - 41-7
LID - S0046-8177(13)00330-4 [pii]
LID - 10.1016/j.humpath.2013.07.038 [doi]
AB  - Studies have shown that fluorescence in situ hybridization (FISH) testing 
      increases lung cancer detection on cytology specimens in peripheral nodules. The 
      goal of this study was to determine whether a predictive model using clinical 
      features and routine cytology with FISH results could predict lung malignancy 
      after a nondiagnostic bronchoscopic evaluation. Patients with an indeterminate 
      peripheral lung nodule that had a nondiagnostic bronchoscopic evaluation were 
      included in this study (N = 220). FISH was performed on residual bronchial 
      brushing cytology specimens diagnosed as negative (n = 195), atypical (n = 16), 
      or suspicious (n = 9). FISH results included hypertetrasomy (n = 30) and negative 
      (n = 190). Primary study end points included lung cancer status along with time 
      to diagnosis of lung cancer or date of last clinical follow-up. Hazard ratios 
      (HRs) were calculated using Cox proportional hazards regression model analyses, 
      and P values < .05 were considered statistically significant. The mean age of the 
      220 patients was 66.7 years (range, 35-91), and most (58%) were men. Most 
      patients (79%) were current or former smokers with a mean pack year history of 
      43.2 years (median, 40; range, 1-200). After multivariate analysis, 
      hypertetrasomy FISH (HR = 2.96, P < .001), pack years (HR = 1.03 per pack year up 
      to 50, P = .001), age (HR = 1.04 per year, P = .02), atypical or suspicious 
      cytology (HR = 2.02, P = .04), and nodule spiculation (HR = 2.36, P = .003) were 
      independent predictors of malignancy over time and were used to create a 
      prediction model (C-statistic = 0.78). These results suggest that this 
      multivariate model including test results and clinical features may be useful 
      following a nondiagnostic bronchoscopic examination.
CI  - (c) 2013.
FAU - Voss, Jesse S
AU  - Voss JS
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 
      55905, USA.
FAU - Iqbal, Seher
AU  - Iqbal S
FAU - Jenkins, Sarah M
AU  - Jenkins SM
FAU - Henry, Michael R
AU  - Henry MR
FAU - Clayton, Amy C
AU  - Clayton AC
FAU - Jett, James R
AU  - Jett JR
FAU - Kipp, Benjamin R
AU  - Kipp BR
FAU - Halling, Kevin C
AU  - Halling KC
FAU - Maldonado, Fabien
AU  - Maldonado F
LA  - eng
PT  - Journal Article
DEP - 20131016
PL  - United States
TA  - Hum Pathol
JT  - Human pathology
JID - 9421547
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bronchoscopy
MH  - Cytodiagnosis
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Lung Diseases/diagnosis
MH  - Lung Neoplasms/*diagnosis
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
OTO - NOTNLM
OT  - Bronchoscopy
OT  - Cytology
OT  - Lung cancer
OT  - Pulmonary nodule
EDAT- 2013/10/22 06:00
MHDA- 2014/02/05 06:00
CRDT- 2013/10/22 06:00
PHST- 2013/05/22 00:00 [received]
PHST- 2013/07/26 00:00 [revised]
PHST- 2013/07/31 00:00 [accepted]
PHST- 2013/10/22 06:00 [entrez]
PHST- 2013/10/22 06:00 [pubmed]
PHST- 2014/02/05 06:00 [medline]
AID - S0046-8177(13)00330-4 [pii]
AID - 10.1016/j.humpath.2013.07.038 [doi]
PST - ppublish
SO  - Hum Pathol. 2014 Jan;45(1):41-7. doi: 10.1016/j.humpath.2013.07.038. Epub 2013 
      Oct 16.