Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: Is measuring solid component size a better prognostic indicator?

被引:114
作者
Hwang, Eui Jin [1 ,2 ]
Park, Chang Min [1 ,2 ,3 ]
Ryu, Youngjin [1 ,2 ]
Lee, Sang Min [1 ,2 ]
Kim, Young Tae [3 ,4 ]
Kim, Young Whan [5 ,6 ]
Goo, Jin Mo [1 ,2 ,3 ]
机构
[1] Seoul Natl Univ, Coll Med, Dept Radiol, Seoul 110744, South Korea
[2] Seoul Natl Univ, Med Res Ctr, Inst Radiat Med, Seoul 110744, South Korea
[3] Seoul Natl Univ, Canc Res Inst, Seoul 110744, South Korea
[4] Seoul Natl Univ, Coll Med, Dept Thorac & Cardiovasc Surg, Seoul 110744, South Korea
[5] Seoul Natl Univ, Coll Med, Div Pulm & Crit Care Med, Dept Internal Med, Seoul 110744, South Korea
[6] Seoul Natl Univ, Coll Med, Lung Inst, Seoul 110744, South Korea
关键词
Lung adenocarcinoma; Computed tomography; Neoplasm staging; Survival; Prognosis; THIN-SECTION CT; RESOLUTION COMPUTED-TOMOGRAPHY; HAZARDS REGRESSION-MODELS; IA LUNG ADENOCARCINOMA; CUBIC SPLINE FUNCTIONS; IASLC/ATS/ERS CLASSIFICATION; TUMOR SIZE; CANCER; OPACITY; REVISION;
D O I
10.1007/s00330-014-3441-1
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
100231 [临床病理学]; 100902 [航空航天医学];
摘要
Objective To assess whether measuring the solid portion of adenocarcinomas appearing as part-solid ground-glass nodules (GGNs) can predict a patient's prognosis accurately and how the prognosis corresponds to that of solid nodules. Methods 501 patients (solid nodule group, 304; part-solid GGN group, 197) underwent curative surgery for stage I adenocarcinomas. Maximal diameters of the whole lesion including ground-glass opacities (D-whole) and solid components only (D-solid) were measured on CT. Disease-free survival (DFS) and overall survival (OS) were calculated from the date of surgery. Results D-solid was a significant prognostic factor in the part-solid GGN group, while D-whole was not. Part-solid GGNs with D-solid <= 2 cm showed significantly better DFS (P=0.016) and OS (P=0.004) than solid nodules; however, those with D-solid>2 cm did not show a significant difference. Hazard ratio (HR) for increase in D-solid was significantly greater in part-solid GGNs than in solid nodules (P=0.009). For OS, HR for increase in D-solid was greater in part-solid GGNs than in solid nodule, which was marginally not significant (P=0.060). Conclusion D-solid was better than D-whole for prognosis prediction of adenocarcinomas appearing as part-solid GGNs. In addition, the influence of D-solid on prognosis in the part-solid GGN group was greater than in the solid nodule group.
引用
收藏
页码:558 / 567
页数:10
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