Suzuki Kenji
General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2017 Apr;9(Suppl 3):S201-S207. doi: 10.21037/jtd.2017.04.03.
Ground glass opacity (GGO) is a good prognostic indicator for lung cancer and is useful for physicians to predict prognosis. Due to recent advances in computed tomography (CT), the chance to encounter GGO is rapidly increasing in clinical practice. Based on the studies on radiological pathological correlation, GGO represents pathological lepidic growth and consolidation on CT represents pathologically invasive components. Thus, consolidation tumor ratio 0.5 or less means pathological less invasiveness for lung cancer. Not a few studies have shown that sublobar resection is equivalent to lobectomy for radiological early lung cancers. Additionally, observation of GGO is one of the options for physicians. Indication of surgical intervention remains unclear. Physician observing GGO in practice should know the natural history of GGO to reach an optimal treatment decision. For multifocal GGO lesions clinical management is surely challenging. Whack-a-mole strategy, which means sublobar resection for radiological invasive cancer is one of the most promising strategies for such lesions.
磨玻璃影（GGO）是肺癌的一个良好预后指标，有助于医生预测预后。由于计算机断层扫描（CT）技术的最新进展，在临床实践中遇到GGO的机会正在迅速增加。基于放射学与病理学相关性的研究，GGO代表病理上的鳞屑样生长，而CT上的实变代表病理上的浸润成分。因此，实变肿瘤比小于或等于0.5意味着肺癌的病理侵袭性较小。不少研究表明，对于放射学上早期肺癌，亚肺叶切除与肺叶切除效果相当。此外，对GGO进行观察也是医生的选择之一。手术干预的指征仍不明确。在实践中观察GGO的医生应了解GGO的自然病程，以做出最佳治疗决策。对于多灶性GGO病变，临床管理无疑具有挑战性。“打地鼠”策略，即对放射学上的浸润性癌进行亚肺叶切除，是针对此类病变最有前景的策略之一。
