From the Research Center for Cancer Prevention and Screening, Division of Screening (R.K., Y.M., N.M.), Department of Diagnostic Radiology (R.K., M.K.), Department of Endoscopy, Respiratory Endoscopy Division (T.T.), Division of Pathology (K.T., A.M.M.), and Department of Thoracic Surgery (H.A.), National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0051 Japan; Department of Radiology, National Cancer Center Hospital East, Tokyo, Japan (M.K.); Department of General Thoracic Surgery, Keio University Hospital, Tokyo, Japan (H.A.); and Department of Radiology, Tokyo Midtown Medical Center, Tokyo, Japan (N.M.).
Radiology. 2015 Sep;276(3):873-82. doi: 10.1148/radiol.2015141071. Epub 2015 Apr 23.
To clarify the percentage of solitary pure ground-glass nodules (SPGGNs) 5 mm or smaller that grow and develop into invasive adenocarcinomas.
This study was approved by the institutional review board, and informed consent was obtained from all people who were screened. From February 2004 through December 2007, 7294 participants underwent screening for lung cancer with computed tomographic (CT) imaging. The nodule database was reviewed to identify SPGGNs 5 mm or smaller. Growth of the SPGGNs was evaluated as of March 31, 2013. In cases of pathologic analysis-proven adenocarcinomas that developed from SPGGNs 5 mm or smaller, solid components were evaluated. Percentages, 95% confidence intervals, and means were calculated.
At baseline screening, 438 SPGGNs 5 mm or smaller were identified, and during the study period one SPGGN 5 mm or smaller developed de novo. Of the 439 SPGGNs, 394 were stable and 45 (10.3% [95% confidence interval: 7.5%, 13.7%]), including newly developed SPGGN, grew. Of the 45 SPGGNs that grew, 0.9% (four of 439 [95% confidence interval: 0.3%, 2.3%]) developed into adenocarcinomas (two minimally invasive [including the newly developed SPGGN] and two invasive). The mean period between baseline CT screening and the appearance of solid components in the four adenocarcinomas was 3.6 years.
Of SPGGNs 5 mm or smaller, approximately 10% will grow and 1% will develop into invasive adenocarcinomas or minimally invasive adenocarcinomas. SPGGNs 5 mm or smaller should be rescanned 3.5 years later to look for development of a solid component.
阐明直径为 5 毫米或更小的单纯磨玻璃结节（SPGGN）生长并发展为侵袭性腺癌的百分比。
本研究经机构审查委员会批准，并获得所有接受筛查人群的知情同意。从 2004 年 2 月至 2007 年 12 月，7294 名参与者接受了肺癌 CT 成像筛查。对结节数据库进行了复查，以确定直径为 5 毫米或更小的 SPGGN。截至 2013 年 3 月 31 日，评估了 SPGGN 的生长情况。在经病理分析证实由直径为 5 毫米或更小的 SPGGN 发展而来的腺癌病例中，评估了实性成分。计算了百分比、95%置信区间和平均值。
在基线筛查时，发现了 438 个直径为 5 毫米或更小的 SPGGN，在研究期间，新出现了 1 个直径为 5 毫米或更小的 SPGGN。在 439 个 SPGGN 中，394 个稳定，45 个（10.3%[95%置信区间：7.5%，13.7%]），包括新出现的 SPGGN，生长。在 45 个生长的 SPGGN 中，有 0.9%（4/439[95%置信区间：0.3%，2.3%]）发展为腺癌（2 个微浸润[包括新出现的 SPGGN]和 2 个浸润性）。从基线 CT 筛查到 4 个腺癌出现实性成分的平均时间为 3.6 年。
直径为 5 毫米或更小的 SPGGN 中，约有 10%会生长，1%会发展为浸润性腺癌或微浸润性腺癌。直径为 5 毫米或更小的 SPGGN 应在 3.5 年后再次扫描，以寻找实性成分的发展。
