基于临床ⅠA 期肺腺癌中磨玻璃密度成分的存在，具有不同的临床病理特征和预后。

Distinct Clinicopathologic Characteristics and Prognosis Based on the Presence of Ground Glass Opacity Component in Clinical Stage IA Lung Adenocarcinoma.

机构信息

Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

J Thorac Oncol. 2019 Feb;14(2):265-275. doi: 10.1016/j.jtho.2018.09.026. Epub 2018 Oct 25.

DOI:10.1016/j.jtho.2018.09.026

PMID:30368010

Abstract

INTRODUCTION

We evaluated differences in the clinicopathologic characteristics and prognosis based on the presence of ground glass opacity (GGO) components in small-sized lung adenocarcinoma.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

介绍

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。

方法

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。

结果

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）。