Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
J Thorac Oncol. 2019 Feb;14(2):265-275. doi: 10.1016/j.jtho.2018.09.026. Epub 2018 Oct 25.
We evaluated differences in the clinicopathologic characteristics and prognosis based on the presence of ground glass opacity (GGO) components in small-sized lung adenocarcinoma.
We retrospectively investigated 634 lung adenocarcinomas classed as c-stage IA in the eighth edition TNM classification. Staging was defined according to the solid component size measured by thin-section computed tomography. All tumors were grouped into either a GGO or solid group, based on the presence of a GGO component.
Of the cases, 215 (34%) were classed as c-stage IA1 (T1mi: 88, T1a-GGO: 102, T1a-solid: 25), 255 (40%) as c-stage IA2 (T1b-GGO: 122, T1b-solid: 133), and 164 (26%) as c-stage IA3 (T1c-GGO: 44, T1c-solid: 120). Among the 546 c-stage IA cases excluding the T1mi lesions, Cox regression analysis revealed that presence of GGO was an independently significant prognosticator (p = 0.024). The result was validated in 494 c-stage IA lung adenocarcinomas with a nonpredominant GGO component, showing the presence of GGO as a significant prognosticator (p = 0.048). When we evaluated the prognostic impact of GGO presence in each clinical stage, the 5-year overall survival (OS) was significantly different between the GGO and solid groups (IA1: 97.8% versus 86.6%, p = 0.026; IA2: 89.3% versus 75.2%, p = 0.007; IA3: 88.5% versus 62.3%, p = 0.003). Furthermore, the 5-year overall survival b was distinct in parallel similar pathologic findings when comparing a lepidic versus an invasive component (IA1: 97.9% versus 85.6%, p = 0.031; IA2: 86.1% versus 69.4%, p = 0.007; IA3: 77.5% versus 55.8%, p < 0.001).
Clinicopathologic and oncologic outcomes were disparate based on the presence of a GGO component in the eighth edition TNM classification of c-stage IA lung adenocarcinoma.
我们评估了第八版 TNM 分期中存在磨玻璃密度（GGO）成分的小肺癌腺癌的临床病理特征和预后差异。
我们回顾性调查了 634 例第八版 TNM 分期为 c 期 IA 的肺腺癌病例。分期根据薄层 CT 测量的实性成分大小确定。所有肿瘤均根据是否存在 GGO 成分分为 GGO 组或实性组。
在这些病例中，215 例（34%）被归类为 c 期 IA1（T1mi：88 例，T1a-GGO：102 例，T1a-实性：25 例），255 例（40%）为 c 期 IA2（T1b-GGO：122 例，T1b-实性：133 例），164 例（26%）为 c 期 IA3（T1c-GGO：44 例，T1c-实性：120 例）。在排除 T1mi 病变的 546 例 c 期 IA 病例中，Cox 回归分析显示存在 GGO 是独立的预后因素（p=0.024）。在 494 例具有非优势 GGO 成分的 c 期 IA 肺腺癌中验证了这一结果，表明存在 GGO 是一个显著的预后因素（p=0.048）。当我们评估 GGO 存在对每个临床分期的预后影响时，GGO 组和实性组的 5 年总生存率（OS）有显著差异（IA1：97.8%比 86.6%，p=0.026；IA2：89.3%比 75.2%，p=0.007；IA3：88.5%比 62.3%，p=0.003）。此外，当比较贴壁型与侵袭型成分时，在具有相似病理发现的情况下，5 年总生存 b 也存在显著差异（IA1：97.9%比 85.6%，p=0.031；IA2：86.1%比 69.4%，p=0.007；IA3：77.5%比 55.8%，p<0.001）。
第八版 TNM 分期中 c 期 IA 肺腺癌存在 GGO 成分时，临床病理和肿瘤学结局存在差异。
