Wei Shi-You, Zhao Ke-Jia, Guo Cheng-Lin, Mei Jian-Dong, Pu Qiang, Ma Lin, Che Guo-Wei, Chen Long-Qi, Wu Zhu, Wang Yun, Kou Ying-Li, Lin Yi-Dan, Li Wei-Min, Liu Lun-Xu
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2017 May;48(3):359-362.
To retrospectively investigate the clinical characteristics, surgical treatments of the patients with lung ground-glass opacities (GGO).
All the patients, who underwent surgical resection of GGO in our department from Jan. 2013 to Dec. 2016 were retrospectively reviewed. The clinicpathological features were analyzed.
A total of 663 patients were included in this study. The rate of malignancy was 92.6% (614/663). The diameter of GGO in benign group [(0.8±0.2) cm] was significant smaller than that in malignant group [ (1.5±0.8) cm](<0.001). The rate of irregular margin in malignant group was far higher than that in benign group (93.8% vs. 20.4%, <0.001), but other CT signs such as vacuole sign, plural retraction, speculation and lobulation did not show significant difference between the two groups. A total of 652 (98.3%) cases were resected by video-assisted thoracoscopic surgery (VATS), and only 11 (1.7%) cases were resected by thoracotomy. A total of 336 (50.7%) patients underwent lobectomy, 226 (34.1%) underwent segmentectomy and 101 (15.2%) undewent wedge resection. The rate of surgery-related complications was 9.0% (60/663), and one (0.2%) patient died.
With careful selection of GGO by experienced surgeons, the rate of malignancy is very high. Surgical resection may be recommended for highly suspected malignant cases. Sublobar resection or lobcotomy by VATS can achieve good treatment effect.
回顾性研究肺磨玻璃影（GGO）患者的临床特征及手术治疗情况。
回顾性分析2013年1月至2016年12月在我科接受GGO手术切除的所有患者。分析其临床病理特征。
本研究共纳入663例患者。恶性率为92.6%（614/663）。良性组GGO直径[（0.8±0.2）cm]明显小于恶性组[（1.5±0.8）cm]（<0.001）。恶性组边缘不规则率远高于良性组（93.8%对20.4%，<0.001），但两组间其他CT征象如空泡征、胸膜牵拉、毛刺及分叶等差异无统计学意义。共652例（98.3%）患者行电视辅助胸腔镜手术（VATS）切除，仅11例（1.7%）患者行开胸手术。共336例（50.7%）患者行肺叶切除术，226例（34.1%）行肺段切除术，101例（15.2%）行楔形切除术。手术相关并发症发生率为9.0%（60/663），1例（0.2%）患者死亡。
经验丰富的外科医生仔细筛选GGO，恶性率很高。对于高度怀疑恶性的病例可推荐手术切除。VATS行肺叶下切除或肺叶切除可取得良好治疗效果。
