亚厘米纯磨玻璃密度结节肺腺癌的CT特征对其浸润性的预测价值

doi:10.3969/j.issn.2095-9400.2019.11.010

Abstract
Figure/Table
References (0)
Related Citation (0)

Download: PDF (1302 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To evaluate the value of CT features in predicting the invasiveness of sub-centimeter lung adenocarcinoma presenting as pure ground-glass nodule (pGGN). Methods: The imaging, pathological and clinical data of 124 cases (131 lesions) of lung adenocarcinoma proved by surgery and pathology of pGGN (≤1 cm) from January 2012 to December 2017 were retrospectively analyzed. All lesions were divided into pre-invasive group (87 lesions) and invasive group (44 lesions) according to histopathology. The size and density differences between the two groups were compared, as well as the location, lung-tumor interface, margin morphology, air bronchogram and vascular changes of the lesions between the pre-invasive lesion group and the invasive lesion group. The independent risk factors for evaluating the invasiveness of sub-centimeter pGGN were analyzed. And the cut-off point of size for differentiating pre-invasive lesions from invasive lesions were calculated. Results: There were statistical differences in size, marginal morphology and vascular changes between the two groups (P<0.05). ROC curve showed that the cut-off point of size in pre-invasive and invasive lesions was 8.5 mm. Multivariate logistic regression analysis showed that maximum diameter (≥8.5 mm), vascular abnormalities and spiculate or irregular margin morphology were independent risk factors for lesion invasiveness, with odds ratios (95%CI) of 2.277(1.006-5.152), 2.628(1.140-6.059) and 3.693(1.251-10.901), respectively. Conclusion: Maximum diameter (≥8.5 mm), vascular abnormalities and spiculate or irregular margin are independent risk factors for subcentimeter pGGN invasiveness.

Key words： pure ground-glass nodule lung adenocarcinoma tomography, X-ray computed pathology

Received: 27 March 2019

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	HUANG Dingpin
	FU Gangze
	CAI Mengting
	ZHUANG Yuandi
	CHEN Lifang
	LIU Jinjin
	XIA Tianyi
	YANG Yunjun

URL:

https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2019.11.010 OR https://xb.wmu.edu.cn/EN/Y2019/V49/I11/837

[1] MATSUGUMA H, MORI K, NAKAHARA R, et al. Characteristics of subsolid pulmonary nodules showing growth during follow-up with CT scanning[J]. Chest, 2013, 143(2): 436-443.
[2] CHANG B, HWANG J H, CHOI Y H, et al. Natural history of pure ground-glass opacity lung nodules detected by low-dose CT scan[J]. Chest, 2013, 143(1): 172-178.
[3] TAMURA M, SHIMIZU Y, YAMAMOTO T, et al. Predictive value of one-dimensional mean computed tomography value of ground-glass opacity on high-resolution images for the possibility of future change[J]. J Thorac Oncol, 2014, 9(4): 469-472.
[4] BOLAND J M, FROEMMING A T, WAMPFLER J A, et al. Adenocarcinoma in situ, minimally invasive adenocarcinoma, and invasive pulmonary adenocarcinoma-analysis of interobserver agreement, survival, radiographic characteristics, and gross pathology in 296 nodules[J]. Hum Pathol, 2016, 51: 41-50.
[5] VAN SCHIL P E, ASAMURA H, RUSCH V W, et al. Surgical implications of the new IASLC/ATS/ERS adenocarcinoma classification[J]. Eur Respir J, 2012, 39(2): 478-486.
[6] LEE S M, PARK C M, GOO J M, et al. Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground glass nodules: differentiation by using CT features [J]. Radiology, 2013, 268(1): 265-273.
[7] YOON H E, FUKUHARA K, MICHIURA T, et al. Pulmonary nodules 10 mm or less in diameter with ground-glass opacity component detected by high-resolution computed tomography have a high possibility of malignancy[J]. Jpn J Thorac Cardiovasc Surg, 2005, 53(1): 22-28.
[8] SAKURAI H, NAKAGAWA K, WATANABE S, et al. Clinicopathologic features of resected subcentimeter lung cancer [J]. Ann Thorac Surg, 2015, 99(5): 1731-1738.
[9] LEE H J, KIM Y T, KANG C H, et al. Epidermal growth factor receptor mutation in lung adenocarcinomas: relationship with CT characteristics and histologic subtypes[J]. Radiology, 2013, 268(1): 254-264.
[10] TRAVIS W D, BRAMBILLA E, NICHOLSON A G, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification[J]. J Thorac Oncol, 2015, 10(9): 1243-1260.
[11] TRAVIS W D, BRAMBILLA E, NOGUCHI M, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of lung adenocarcinoma: executive summary[J]. Proc Am Thorac Soc, 2011, 8(5): 381-385.
[12] NAIDICH D P, BANKIER A A, MACMAHON H, et al. Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society[J]. Radiology, 2013, 266(1): 304-317.
[13] 金鑫, 赵绍宏, 高洁, 等. 纯磨玻璃密度肺腺癌病理分类及影像表现特点分析[J]. 中华放射学杂志, 2014, 48(4): 283-287.
[14] WU F, TIAN S P, JIN X, et al. CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter[J]. Eur Radiol, 2017, 27(10): 4037-4043.
[15] GAO F, LI M, GE X, et al. Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels[J]. Eur Radiol, 2013, 23(12): 3271-3277.
[16] LEE H Y, LEE K S. Ground-glass opacity nodules histopathology, imaging evaluation, and clinical implications[J]. J Thoracic Imaging, 2011, 26(2): 106-118.
[17] IMAI K, MINAMIYA Y, GOTO A, et al. Bronchioloalveolar invasion in non-small cell lung cancer is associated with expression of transforming growth factor-β1[J]. World J Surg Oncol, 2013, 11: 113.
[18] FRIDMAN W H, DIEU-NOSJEAN M C, PAGES F, et al. The immune microenvironment of human tumors: general significance and clinical impact[J]. Cancer Microenviron, 2013, 6(2): 117-122.
[19] FAN L, LIU S Y, LI Q C, et al. Pulmonary malignant focal ground-glass opacity nodules and solid nodules of 3cm or less: comparison of multi-detector CT features[J]. J Med Imaging Radiat Oncol, 2011, 55(3): 279-285.
[20] IKEDA K, AWAI K, MORI T, et a1. Differential diagnosis of ground-glass opacity nodules: CT number analysis by three-dimensional computerized quantification[J]. Chest, 2007, 132(3): 984-990.
[21] LEE H Y, CHOI Y L, LEE K S, et al. Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management[J]. AJR Am J Roentgenol, 2014, 202(3): W224-W233.
[22] 吴芳, 蔡祖龙, 田树平, 等. 首次临床及CT表现对长期存在≤10 mm纯磨玻璃密度结节进展的预测价值[J]. 中国医学科学院学报, 2016, 38(4): 371-377.
[23] 高丰, 葛虓俊, 李铭, 等. 不同病理类型肺部磨玻璃结节的CT诊断[J]. 中华肿瘤杂志, 2014, 36(3): 188-192.