J Thorac Dis. 2012 Jun 1;4(3):265-71. doi: 10.3978/j.issn.2072-1439.2012.05.09.
Lung cancer is the leading cause of cancer-associated death. In many countries, adenocarcinoma is the most common histologic type in lung cancer. Previously, few factors are identified to be prognostic indicators for the patients with small lung adenocarcinoma. Recently, the ground glass opacity (GGO) area found on high-resolution computed tomography (HRCT) scanning was identified as a prognostic indicator in some studies. But no clear consensus has been defined.
The PubMed/MEDLINE, EMBASE, Cochrane library and SpringerLink electronic databases were searched for articles related to ground glass opacity on computed tomography in patients with small lung adenocarcinoma. Data was extracted and analyzed independently by two investigators. An estimate of the hazard ratio (HR) for comparing high GGO ratio with low GGO ratio was extracted. The respective HRs was combined into a pooled HR, and 95% confidence interval (CI) was calculated for each study. The publication heterogeneity was assessed graphically using performing Beggs' funnel plot. All the statistical tests used in our meta-analysis were performed with STATA version 11.
Thirteen studies, encompassing 2,027 patients, were included in our meta-analysis. Ten of these studies revealed that the GGO ratio in small lung adenocarcinoma is a good prognostic indicator. Seven studies were combined in a meta-analysis using overall survival (OS) as the end point of interest. The weighted HR of 7 studies was 0.85, with relative 95% CI ranging from 0.78 to 0.93 (P=0.009). For the surgical patient population, the primary endpoint of relapse-free survival (RFS) was superior with high GGO area on computed tomography (The combined HR 0.82, 95% CI 0.74-0.90; P=0.007).
The result of our meta-analysis suggested that the GGO area measured on HRCT had a prognostic value of overall survival and relapse-free survival in small lung adenocarcinoma. The GGO ratio may be an independent prognostic factor for small lung adenocarcinoma.
肺癌是癌症相关死亡的主要原因。在许多国家，腺癌是肺癌中最常见的组织学类型。以前，很少有因素被确定为小肺腺癌患者的预后指标。最近，高分辨率计算机断层扫描（HRCT）扫描上发现的磨玻璃样混浊（GGO）区域在一些研究中被确定为预后指标。但尚未达成明确共识。
在 PubMed/MEDLINE、EMBASE、Cochrane 图书馆和 SpringerLink 电子数据库中搜索有关小肺腺癌患者 CT 扫描上磨玻璃样混浊的文章。数据由两位研究者独立提取和分析。提取并比较高 GGO 比与低 GGO 比的危险比（HR）。将各自的 HR 合并为一个汇总 HR，并计算每个研究的 95%置信区间（CI）。使用 Beggs 漏斗图图形评估发表偏倚。我们荟萃分析中使用的所有统计检验均使用 STATA 版本 11 进行。
纳入了 13 项研究，共 2027 例患者。其中 10 项研究表明，小肺腺癌中的 GGO 比是一个良好的预后指标。7 项研究使用总生存（OS）作为感兴趣的终点进行荟萃分析。7 项研究的加权 HR 为 0.85，相对 95%CI 范围为 0.78 至 0.93（P=0.009）。对于手术患者人群，CT 上高 GGO 区域的无复发生存（RFS）主要终点更优（联合 HR 0.82，95%CI 0.74-0.90；P=0.007）。
荟萃分析的结果表明，HRCT 上测量的 GGO 区域对小肺腺癌的总生存和无复发生存具有预后价值。GGO 比可能是小肺腺癌的独立预后因素。
