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对在计算机断层扫描随访检查后切除的磨玻璃样混浊对应的病变进行评估。

Evaluation of lesions corresponding to ground-glass opacities that were resected after computed tomography follow-up examination.

作者信息

Sawada Shigeki, Komori Eisaku, Nogami Naoyuki, Segawa Yoshihiko, Shinkai Tetsu, Yamashita Motohiro

机构信息

Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, Japan.

出版信息

Lung Cancer. 2009 Aug;65(2):176-9. doi: 10.1016/j.lungcan.2008.11.013. Epub 2009 Jan 9.

Abstract

BACKGROUND

Ground-glass opacity (GGO), which is closely related with bronchioloalveolar carcinoma (BAC), is being detected more frequently. BAC is considered to be a relatively less aggressive tumor, and immediate resection at the time of detection might not be necessary. Therefore, when GGO is detected, a CT follow-up examination is often performed. If growth is detected during the follow-up CT examination, resection is usually considered. However, the possible treatment delay caused by the scheduling of a CT follow-up examination is an issue that must be clarified. Since the cancer might progress during the follow-up period, such follow-up periods might have a negative influence on the patient's prognosis. This study attempted to clarify whether CT follow-up causes treatment delay.

METHODS

A total of 113 lung cancer patients with pure or mixed GGO findings who underwent a resection after a CT follow-up examination between 1999 and 2005 were retrospectively examined. The CT findings at the initial detection, the changes in the CT findings during the CT follow-up period, the histology, the pathological stage and the outcomes after resection were reviewed and evaluated.

RESULTS

The CT finding at the time of the initial detection showed pure GGO in 63 patients and mixed GGO in 50 patients. Histology revealed that adenocarcinoma was found in all 113 patients; squamous cell carcinoma was not found in any of the patients. One-hundred twelve patients were diagnosed as having Stage IA, and a singe patient with visceral pleura invasion was diagnosed as having Stage IB. Complete resections were performed in all the patients. The median postoperative follow-up period was 45.0 months. No recurrences or deaths were observed during the study period.

CONCLUSIONS

No treatment delays or negative influences on patient outcome resulted from the CT follow-up period. A future prospective study should be conducted to establish the optimal CT follow-up program.

摘要

背景

磨玻璃影(GGO)与细支气管肺泡癌(BAC)密切相关,其检出率日益增加。BAC被认为是一种侵袭性相对较低的肿瘤,在发现时可能无需立即切除。因此,当检测到GGO时,通常会进行CT随访检查。如果在随访CT检查中发现病变生长,通常会考虑进行切除。然而,CT随访检查的安排可能导致的治疗延迟是一个必须明确的问题。由于癌症可能在随访期间进展,这样的随访期可能会对患者的预后产生负面影响。本研究试图阐明CT随访是否会导致治疗延迟。

方法

回顾性研究了1999年至2005年间113例经CT随访检查后接受手术切除的纯磨玻璃影或混合磨玻璃影肺癌患者。对初始检测时的CT表现、CT随访期间CT表现的变化、组织学、病理分期及切除后的结局进行了回顾和评估。

结果

初始检测时的CT表现显示,63例患者为纯磨玻璃影,50例患者为混合磨玻璃影。组织学检查显示,所有113例患者均为腺癌,未发现鳞状细胞癌。112例患者被诊断为IA期,1例侵犯脏层胸膜的患者被诊断为IB期。所有患者均接受了完整切除。术后中位随访期为45.0个月。研究期间未观察到复发或死亡病例。

结论

CT随访期未导致治疗延迟或对患者预后产生负面影响。未来应进行前瞻性研究以建立最佳的CT随访方案。

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