Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan; Division of Respiratory Surgery, Nihon University School of Medicine, Tokyo, Japan.
Ann Thorac Surg. 2018 May;105(5):1499-1506. doi: 10.1016/j.athoracsur.2018.01.019. Epub 2018 Feb 7.
Ground glass opacity (GGO)-dominant lung adenocarcinoma sized 3.0 cm or less in the whole tumor size is widely known to have an excellent prognosis and is regarded as early lung cancer. However, the characteristics and prognosis of lung cancer showing GGO exceeding 3.0 cm remains unclear.
From 2002 through 2012, we reviewed 3,735 lung cancers that underwent complete resection at our institution. We identified 160 lung cancers (4.3%) showing GGO exceeding 3.0 cm on thin-section computed tomography and divided them into three types by the consolidation/tumor ratio (CTR) using cutoff values of 0.25 and 0.5. We compared the characteristics and prognosis among these types.
Type A (CTR, 0 to ≤0.25), type B (CTR, >0.25 to ≤0.5), and type C (CTR, >0.5 to <1.0) were found in 16 (10%), 37 (23%), and 107 lesions (67%), respectively. No lymph node metastasis was found in types A and B. Recurrence was not observed in types A and B. The 5-year overall survival and disease-free survival rates were both 100% in type A, both 97.2% in type B, and 88.4% and 66.7% in type C, respectively. Patients with type C had a significantly worse prognosis than those with the other types with respect to overall survival and disease-free survival.
A patient with GGO-dominant lung cancer exceeding 3.0 cm can be considered to be in a group of patients with nodal-negative disease and an excellent prognosis.
直径≤3.0cm 的以磨玻璃密度（GGO）为主的肺腺癌被广泛认为具有良好的预后，被视为早期肺癌。然而，直径超过 3.0cm 的以 GGO 为主的肺癌的特征和预后尚不清楚。
我们回顾了 2002 年至 2012 年间在我院接受完全切除术的 3735 例肺癌患者。我们发现 160 例在薄层 CT 上表现出 GGO 超过 3.0cm 的肺癌，并使用 0.25 和 0.5 的分界值通过肿瘤实性成分比（CTR）将它们分为三种类型。我们比较了这些类型之间的特征和预后。
A 型（CTR，0 至≤0.25）、B 型（CTR，>0.25 至≤0.5）和 C 型（CTR，>0.5 至<1.0）分别占 16（10%）、37（23%）和 107 例（67%）。A 型和 B 型均未发现淋巴结转移。A 型和 B 型均未复发。A 型的 5 年总生存率和无病生存率均为 100%，B 型均为 97.2%，C 型分别为 88.4%和 66.7%。与其他类型相比，C 型患者的总生存率和无病生存率明显更差。
直径超过 3.0cm 的以 GGO 为主的肺癌患者可以被认为是一组淋巴结阴性且预后良好的患者。
