Journal
TRANSLATIONAL LUNG CANCER RESEARCH
Volume 9, Issue 4, Pages 1516-+Publisher
AME PUBLISHING COMPANY
DOI: 10.21037/tlcr-20-892
Keywords
Coronavirus disease 2019 (COVID-19); lung neoplasms; ground glass opacity; radiology; propensity score
Categories
Funding
- National Natural Science Foundation of China [81871882, 81902951]
- Shanghai Municipal Commission of Health and Family Planning Outstanding Academic Leaders Training Program [2017BR055]
- Shanghai Municipal Education Commission - Gaofeng Clinical Medicine Grant [20172005]
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Background: Radiological manifestations of coronavirus disease 2019 (COVID-19) featured ground-glass opacities (GGOs), especially in the early stage, which might create confusion in differential diagnosis with early lung cancer. We aimed to specify the radiological characteristics of COVID-19 and early lung cancer and to unveil the discrepancy between them. Methods: One hundred and fifty-seven COVID-19 patients and 374 early lung cancer patients from four hospitals in China were retrospectively enrolled. Epidemiological, clinical, radiological, and pathological characteristics were compared between the two groups using propensity score-matched (PSM) analysis. Results: COVID-19 patients had more distinct symptoms, tended to be younger (P<0.0001), male (P<0.0001), and had a higher body mass index (P=0.014). After 1:1 PSM, 121 matched pairs were identified. Regarding radiological characteristics, patients with a single lesion accounted for 17% in COVID-19 and 89% in lung cancer (P<0.0001). Most lesions were peripherally found in both groups. Lesions in COVID-19 involved more lobes (median 3.5 vs. 1; P<0.0001) and segments (median 6 vs. 1; P<0.0001) and tended to have multiple types (67%) with patchy form (54%). Early lung cancer was more likely to have a single type (92%) with oval form (66%). Also, COVID-19 and early lung cancer either had some distinctive features on computed tomography (CT) images. Conclusions: Both COVID-1 9 and early lung cancers showed GGOs, with similar but independent features. The imaging characteristics should be fully understood and combined with epidemiological history, pathogen detection, laboratory tests, short-term CT reexamination, and pathological results to aid differential diagnosis.
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