Department of Thoracic and Cardiovascular Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Ann Thorac Surg. 2013 Dec;96(6):1952-7. doi: 10.1016/j.athoracsur.2013.07.071. Epub 2013 Sep 29.
Detection of ground-glass nodules (GGNs) on computed tomography (CT) is increasing due to advances in CT technology and the findings of the National Lung Screening Trial. Ground-glass nodules are detected on screening chest CTs and CT scans after lung resection surgery. It is important to investigate the natural history of GGNs as it is not yet well known, and a standardized approach to manage them has not been established.
We selected patients who presented with GGNs on chest CT taken after major lung resection. One hundred thirty-nine GGNs were detected in 92 patients and followed up for longer than 1 year. Characteristics of GGN, size, presence of a solid component and multiplicity, and demographic data of patients such as history of smoking and malignant disease were analyzed to identify factors that affected GGN growth.
During the follow-up period (mean 44.4 months), 23 GGNs showed a significant increase in size. The only predictor for the growth of GGNs was the presence of a solid component (p < 0.001). Pathologic diagnosis was made in 14 patients. Of those, 10 GGNs including 7 primary lung adenocarcinomas were diagnosed as malignant. Three of 4 benign lesions were diagnosed as atypical adenomatous hyperplasia. There were no mortalities directly related to GGNs.
In GGNs detected on CT scans of patients who had undergone major lung resection, the presence of a solid component was the only factor that could predict nodule growth. Although the majority of growing GGNs were adenocarcinoma, the clinical course seemed to be indolent.
由于 CT 技术的进步和全国肺癌筛查试验的结果，在计算机断层扫描（CT）上检测到的磨玻璃结节（GGN）越来越多。在筛查性胸部 CT 和肺切除术后的 CT 扫描中检测到磨玻璃结节。由于对 GGN 的自然史了解甚少，尚未建立标准化的管理方法，因此对其进行研究非常重要。
我们选择了在大肺切除术后胸部 CT 上出现 GGN 的患者。92 例患者共检出 139 个 GGN，随访时间超过 1 年。分析 GGN 的特征、大小、实性成分的存在和多发性，以及患者的人口统计学数据（如吸烟史和恶性疾病史），以确定影响 GGN 生长的因素。
在随访期间（平均 44.4 个月），23 个 GGN 大小明显增大。GGN 生长的唯一预测因素是实性成分的存在（p < 0.001）。14 例患者进行了病理诊断。其中 10 个 GGN 包括 7 个原发性肺腺癌被诊断为恶性。4 个良性病变中有 3 个被诊断为不典型腺瘤样增生。没有与 GGN 直接相关的死亡病例。
在大肺切除术后 CT 扫描中检测到的 GGN 中，实性成分的存在是唯一可以预测结节生长的因素。虽然大多数生长的 GGN 是腺癌，但临床过程似乎是惰性的。
