Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan.
Radiology. 2012 Aug;264(2):590-6. doi: 10.1148/radiol.12111337. Epub 2012 May 31.
To retrospectively identify successive changes in peripheral lung adenocarcinoma that feature dominant ground-glass opacity (GGO) at computed tomography (CT) and correlate with biomolecular markers.
The institutional review board approved this retrospective study, and all 25 patients provided informed consent. Patients with lung adenocarcinomas smaller than 3 cm in diameter in whom tumor growth could be evaluated with CT before surgery were included. Two thoracic radiologists evaluated tumor growth by analyzing GGO type (pure or mixed) and size increases. Immunohistochemistry of the p53 protein and molecular analysis of the epidermal growth factor receptor (EGFR) and K-ras genes were performed. The Fisher exact test was used to assess statistical significance.
Tumor size increased in 19 of 25 patients (76%) during the observation period. The CT changes in 19 patients were classified into four patterns: persistent pure GGO (n = 8), change from pure to mixed GGO (n = 3), mixed GGO with growth of solid component (n = 4), and mixed GGO with growth of GGO component (n = 4). The remaining six patients (24%) had pure GGO without any interval changes. Staining for p53 was negative in all 14 patients with pure GGO and positive in six of 11 patients (55%) with mixed GGO (P < .01). In these six patients appearance or growth of the solid component was seen. EGFR mutations were found in both pure (36%) and mixed (45%) GGO lesions (P = .70).
Lung adenocarcinomas with a dominant GGO often possess EGFR mutations. Interval changes in the solid component may be related to p53 inactivation.
回顾性分析以 CT 表现为主的磨玻璃密度（GGO）的周围型肺腺癌的连续变化，并与生物分子标志物相关联。
该回顾性研究经机构审查委员会批准，所有 25 例患者均提供了知情同意书。纳入了肿瘤直径小于 3cm 的肺腺癌患者，这些患者在手术前可以通过 CT 评估肿瘤生长情况。两名胸部放射科医生通过分析 GGO 类型（纯 GGO 或混合性 GGO）和大小增加来评估肿瘤生长情况。对 p53 蛋白进行免疫组化，对表皮生长因子受体（EGFR）和 K-ras 基因进行分子分析。采用 Fisher 确切检验评估统计学意义。
在观察期间，25 例患者中有 19 例（76%）肿瘤大小增加。19 例患者的 CT 变化分为四种类型：持续纯 GGO（n = 8）、纯 GGO 变为混合性 GGO（n = 3）、混合性 GGO 实性成分生长（n = 4）和混合性 GGO GGO 成分生长（n = 4）。其余 6 例（24%）患者仅为纯 GGO，无任何间隔变化。14 例纯 GGO 患者的 p53 染色均为阴性，11 例混合性 GGO 患者中 6 例（55%）阳性（P <.01）。这 6 例患者出现了实性成分的外观或生长。纯 GGO（36%）和混合性 GGO（45%）病变均发现 EGFR 突变（P =.70）。
以 GGO 为主的肺腺癌常伴有 EGFR 突变。实性成分的间隔变化可能与 p53 失活有关。
