Ichinose Junji, Kohno Tadasu, Fujimori Sakashi, Harano Takashi, Suzuki Souichiro, Fujii Takeshi
Department of Thoracic Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2014;20(5):347-52. doi: 10.5761/atcs.oa.13-00005. Epub 2013 Oct 3.
We retrospectively investigated the pathological diagnoses of pulmonary lesions presenting as pure ground-glass opacities (GGOs) to evaluate the risk of invasive malignancy.
We examined 191 GGO lesions, including 114 pure GGO and 77 mixed lesions, in 160 patients who underwent resection between January 2008 and December 2010.
Of the 114 pure GGO lesions, 14 (12%) were diagnosed as invasive lung cancer and 16 (14%) as minimally invasive adenocarcinoma. Twenty-one lesions exhibited pleural indentation on high-resolution computed tomography (HRCT), and 5 of these were diagnosed as invasive cancer, indicating an invasive tendency of pure GGO lesions with pleural indentation (odds ratio, 2.64). Of 14 pure GGO lesions positive on positron emission tomography (PET), 8 were diagnosed as invasive lung cancer, indicating an invasive tendency of pure GGO lesions with PET positivity (odds ratio, 16.0; p <0.001; sensitivity, 67%; specificity, 89%).
Invasive lung cancer accounted for 12% of the pure GGO lesions. Pure GGO lesions should be carefully monitored by periodic chest computed tomography, and surgical resection is recommended when they exhibit pleural indentation on HRCT or positivity on PET.
我们回顾性研究了表现为纯磨玻璃影（GGO）的肺部病变的病理诊断，以评估侵袭性恶性肿瘤的风险。
我们检查了2008年1月至2010年12月期间接受手术切除的160例患者中的191个GGO病变，包括114个纯GGO和77个混合性病变。
在114个纯GGO病变中，14个（12%）被诊断为浸润性肺癌，16个（14%）为微浸润腺癌。21个病变在高分辨率计算机断层扫描（HRCT）上显示胸膜凹陷，其中5个被诊断为浸润性癌，表明有胸膜凹陷的纯GGO病变有浸润倾向（优势比，2.64）。在14个正电子发射断层扫描（PET）阳性的纯GGO病变中，8个被诊断为浸润性肺癌，表明PET阳性的纯GGO病变有浸润倾向（优势比，16.0；p<0.001；敏感性，67%；特异性，89%）。
浸润性肺癌占纯GGO病变的12%。纯GGO病变应通过定期胸部计算机断层扫描仔细监测，当它们在HRCT上显示胸膜凹陷或PET阳性时，建议手术切除。
