Persistent Pure Ground-Glass Opacity Lung Nodules ≥ 10 mm in Diameter at CT Scan Histopathologic Comparisons and Prognostic Implications

被引:215
作者
Lim, Hyun-ju [1 ,2 ]
Ahn, Soomin [3 ]
Lee, Kyung Soo [1 ,2 ]
Han, Joungho [3 ]
Shim, Young Mog [4 ]
Woo, Sookyoung [5 ]
Kim, Jae-Hun [1 ,2 ]
Yie, Miyeon [1 ,2 ]
Lee, Ho Yun [1 ,2 ]
Yi, Chin A. [1 ,2 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Dept Radiol, Samsung Med Ctr, Seoul 135710, South Korea
[2] Sungkyunkwan Univ, Sch Med, Ctr Imaging Sci, Samsung Med Ctr, Seoul 135710, South Korea
[3] Sungkyunkwan Univ, Sch Med, Dept Pathol, Samsung Med Ctr, Seoul 135710, South Korea
[4] Sungkyunkwan Univ, Sch Med, Dept Thorac Surg, Samsung Med Ctr, Seoul 135710, South Korea
[5] Sungkyunkwan Univ, Sch Med, Samsung Biomed Res Inst, Samsung Med Ctr, Seoul 135710, South Korea
关键词
SUBSOLID PULMONARY NODULES; PATHOLOGICAL CORRELATION; COMPUTED-TOMOGRAPHY; ADENOCARCINOMA; MANAGEMENT; INDICATOR; RESECTION; SOCIETY; GROWTH; CANCER;
D O I
10.1378/chest.12-2987
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Background: Little is known about the histopathology and prognosis of persistent pure ground-glass opacity nodules (GGNs) of >= 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of >= 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis. Methods: A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for >= 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated. Results: The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram (P = .012), size of nodule (P = .032, cutoff = 16.4 mm in diameter), and mass of nodule (P = .040, cutoff = 0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size (P = .010) and mass of nodule (P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of >= 3 years after surgical resection. Conclusions: In persistent pure GGNs of >= 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
引用
收藏
页码:1291 / 1299
页数:9
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