Hiramatsu Miyako, Inagaki Takuya, Inagaki Tomoya, Matsui Yoshio, Satoh Yukitoshi, Okumura Sakae, Ishikawa Yuichi, Miyaoka Etsuo, Nakagawa Ken
Department of Thoracic Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.
J Thorac Oncol. 2008 Nov;3(11):1245-50. doi: 10.1097/JTO.0b013e318189f526.
Ground-glass opacity (GGO) of the lung is being frequently detected by thin section computed tomography scan. However, the long term management of detected GGO is still unclear. To establish follow-up plans, we performed the clinical and radiological review to identify the factors that are closely associated with GGO growth.
We retrospectively analyzed computed tomography images of 125 GGOs that were stable for 3 months between 1999 and 2006 at the Cancer Institute Hospital, Tokyo. To identify factors that affect the roentgenological growth, the time to GGO growth curve by Kaplan-Meyer method was evaluated in terms of gender, age, smoking, initial size, existence of a solid part, GGO density, location, multiplicity, and lung cancer history by univariate and multivariate analyses.
The median observation period was 1048 days (177-3269) and 26 of 125 GGOs (21%) grew. The estimated growth population for 5 years was 30%. The growth was more frequently seen in the elderly (p = 0.017), in part-solid GGO (p < 0.01) and in GGO of larger than 10 mm (p < 0.01, logrank test). By multivariate analysis, initial size (p < 0.01, Cox's model) and history of lung cancer (p = 0.017, logistic model) were independent factors that were significantly associated with GGO growth. Fifty GGOs that were 10 mm or smaller and without a lung cancer history did not grow within 3.5 years.
After initial management and 3 month follow-up, larger size (more than 10 mm) and a history of lung cancer are risk factors for GGO growth, and therefore should be considered when making a follow-up plan.
薄层计算机断层扫描常可检测到肺部磨玻璃影（GGO）。然而，对于检测到的GGO的长期管理仍不明确。为制定随访计划，我们进行了临床和影像学回顾，以确定与GGO生长密切相关的因素。
我们回顾性分析了1999年至2006年期间在东京癌症研究所医院3个月内稳定的125个GGO的计算机断层扫描图像。为确定影响影像学生长的因素，通过Kaplan - Meyer方法评估GGO生长曲线的时间，采用单因素和多因素分析，涉及性别、年龄、吸烟、初始大小、实性成分的存在、GGO密度、位置、多发性和肺癌病史。
中位观察期为1048天（177 - 3269天），125个GGO中有26个（21%）生长。5年的估计生长率为30%。生长在老年人中更常见（p = 0.017），部分实性GGO中更常见（p < 0.01），以及大于10 mm的GGO中更常见（p < 0.01，对数秩检验）。通过多因素分析，初始大小（p < 0.01，Cox模型）和肺癌病史（p = 0.017，逻辑模型）是与GGO生长显著相关的独立因素。50个10 mm或更小且无肺癌病史的GGO在3.5年内未生长。
在初始管理和3个月随访后，较大尺寸（超过10 mm）和肺癌病史是GGO生长的危险因素，因此在制定随访计划时应予以考虑。
