Lung Adenocarcinomas Manifesting as Radiological Part-Solid Nodules Define a Special Clinical Subtype

被引:310
作者
Ye, Ting [1 ,2 ]
Deng, Lin [3 ]
Wang, Shengping [2 ,4 ]
Xiang, Jiaqing [1 ,2 ]
Zhang, Yawei [1 ,2 ]
Hu, Hong [1 ,2 ]
Sun, Yihua [1 ,2 ]
Li, Yuan [2 ,5 ]
Shen, Lei [2 ,5 ]
Xie, Li [6 ]
Gu, Wenchao [7 ]
Zhao, Yue [1 ,2 ]
Fu, Fangqiu [1 ,2 ]
Peng, Weijun [2 ,4 ]
Chen, Haiquan [1 ,2 ,8 ,9 ]
机构
[1] Fudan Univ, Shanghai Canc Ctr, Dept Thorac Surg, Shanghai, Peoples R China
[2] Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai, Peoples R China
[3] Shanghai Proton & Heavy Ion Ctr, Dept Radiol, Shanghai, Peoples R China
[4] Fudan Univ, Shanghai Canc Ctr, Dept Radiol, Shanghai, Peoples R China
[5] Fudan Univ, Shanghai Canc Ctr, Dept Pathol, Shanghai, Peoples R China
[6] Shanghai Jiao Tong Univ, Clin Res Ctr, Sch Med, Shanghai, Peoples R China
[7] Gunma Univ, Dept Diagnost Radiol & Nucl Med, Grad Sch Med, Maebashi, Gunma, Japan
[8] Fudan Univ, Sch Life Sci, Shanghai, Peoples R China
[9] Fudan Univ, Inst Biomed Sci, Shanghai, Peoples R China
基金
中国国家自然科学基金;
关键词
Part-solid nodule; Lung adenocarcinoma; Prognosis; Solid component size; Tumor size; RESOLUTION COMPUTED-TOMOGRAPHY; GLASS OPACITY COMPONENT; PULMONARY NODULES; TUMOR SIZE; LIMITED RESECTION; WEDGE RESECTION; CANCER; CLASSIFICATION; TRIAL; CT;
D O I
10.1016/j.jtho.2018.12.030
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
Introduction: The clinicopathologic features and prognostic predictors of radiological part-solid lung adenocarcinomas were unclear. Methods: We retrospectively compared the clinicopathologic features and survival times of part-solid tumors with those of pure ground glass nodules (pGGNs) and pure solid tumors treated with surgery at Fudan University Shanghai Cancer Center and evaluated the prognostic implications of consolidation-to-tumor ratio (CTR), solid component size, and tumor size for part-solid lung adenocarcinomas. Results: A total of 911 patients and 988 pulmonary nodules (including 329 part-solid nodules [PSNs], 501 pGGNs, and 158 pure solid nodules) were analyzed. More female patients (p = 0.015) and nonsmokers (p = 0.003) were seen with PSNs than with pure solid nodules. The prevalence of lymphatic metastasis was lower in patients with PSNs than in those with pure solid tumors (2.2% versus 27% [p < 0.001]). The 5-year lung cancer-specific (LCS) recurrence-free survival and LCS overall survival of patients with PSNs were worse than those of patients with pGGNs (p < 0.001 and p = .042, respectively) but better than those of patients with pure solid tumors ([p < 0.001 and p < 0.0001, respectively]). CTR (OR = 12.90; 95% confidence interval [CI]: 1.85-90.04), solid component size (OR = 1.45; 95% CI: 1.28-1.64), and tumor size (OR = 1.23; 95% CI: 1.15-1.31) could predict pathologic invasive adenocarcinoma for patients with PSNs. None of them could predict the prognosis. Patients receiving sublobar resection had prognoses comparable to those of patients receiving lobectomy (p = .178 for 5-year LCS recurrence-free survival and p = .319 for 5-year LCS overall survival). The prognostic differences between patients with systemic lymph node dissection and those without systemic lymph node dissection were statistically insignificant. Conclusions: Part-solid lung adenocarcinoma showed clinicopathologic features different from those of pure solid tumor. CTR, solid component size, and tumor size could not predict the prognosis. Part-solid lung adenocarcinomas define one special clinical subtype. (C) 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:617 / 627
页数:11
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