Kakinuma Ryutaro, Ohmatsu Hironobu, Kaneko Masahiro, Kusumoto Masahiko, Yoshida Junji, Nagai Kanji, Nishiwaki Yutaka, Kobayashi Toshiaki, Tsuchiya Ryosuke, Nishiyama Hiroyuki, Matsui Eisuke, Eguchi Kenji, Moriyama Noriyuki
Division of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwa-no-ha, Kashiwa, Chiba 277-8577, Japan.
J Comput Assist Tomogr. 2004 Jan-Feb;28(1):17-23. doi: 10.1097/00004728-200401000-00003.
To clarify the progression of focal pure ground-glass opacity (pGGO) detected by low-dose helical computed tomography (CT) screening for lung cancer.
A total of 15,938 low-dose helical CT examinations were performed in 2052 participants in the screening project, and 1566 of them were judged to have yielded abnormal findings requiring further examination. Patients with peripheral nodules exhibiting pGGO at the time of the first thin-section CT examination and confirmed histologically by thin-section CT after follow-up of more than 6 months were enrolled in the current study. Progression was classified based on the follow-up thin-section CT findings.
The progression of the 8 cases was classified into 3 types: increasing size (n = 5: bronchioloalveolar carcinoma [BAC]), decreasing size and the appearance of a solid component (n = 2: BAC, n = 1; adenocarcinoma with mixed subtype [Ad], n = 1), and stable size and increasing density (n = 1: BAC). In addition, the decreasing size group was further divided into 2 subtypes: a rapid-decreasing type (Ad: n = 1) and a slow-decreasing type (BAC: n = 1). The mean period between the first thin-section CT and surgery was 18 months (range: 7-38 months). All but one of the follow-up cases of lung cancer were noninvasive whereas the remaining GGO with a solid component was minimally invasive.
The pGGOs of lung cancer nodules do not only increase in size or density, but may also decrease rapidly or slowly with the appearance of solid components. Close follow-up until the appearance of a solid component may be a valid option for the management of pGGO.
阐明低剂量螺旋计算机断层扫描（CT）肺癌筛查中发现的局灶性纯磨玻璃影（pGGO）的进展情况。
在肺癌筛查项目的2052名参与者中进行了15938次低剂量螺旋CT检查，其中1566人被判定有异常发现需要进一步检查。本研究纳入首次薄层CT检查时表现为pGGO且随访6个月以上后经薄层CT组织学确诊的外周结节患者。根据随访薄层CT结果对进展情况进行分类。
8例进展情况分为3种类型：大小增加（n = 5：细支气管肺泡癌[BAC]）、大小减小并出现实性成分（n = 2：BAC，n = 1；混合亚型腺癌[Ad]，n = 1）、大小稳定且密度增加（n = 1：BAC）。此外，大小减小组进一步分为2个亚型：快速减小型（Ad：n = 1）和缓慢减小型（BAC：n = 1）。首次薄层CT与手术之间的平均时间为18个月（范围：7 - 38个月）。除1例肺癌随访病例外，其余均为非侵袭性，而其余带有实性成分的GGO为微侵袭性。
肺癌结节的pGGO不仅大小或密度会增加，还可能随着实性成分的出现而快速或缓慢减小。在实性成分出现之前密切随访可能是管理pGGO的有效选择。
