临床非侵袭性或微侵袭性肺癌患者侵袭性腺癌的预测因素。

Predictive factors for invasive adenocarcinoma in patients with clinical non-invasive or minimally invasive lung cancer.

作者信息

Moon Youngkyu, Park Jae Kil, Lee Kyo Young, Ahn Seha, Shin Jinwon

机构信息

Department of Thoracic & Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

J Thorac Dis. 2018 Nov;10(11):6010-6019. doi: 10.21037/jtd.2018.10.83.

DOI:10.21037/jtd.2018.10.83

PMID:30622772

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6297432/

Abstract

BACKGROUND

Pure ground glass opacity (GGO) or part-solid GGO with small solid component (≤5 mm) are likely to be non-invasive or minimally invasive lung cancer. However, those lesions sometimes are diagnosed as invasive adenocarcinoma postoperatively. The aim of this study was to determine the predictors of invasive adenocarcinoma in clinical non- or minimally invasive lung cancer.

METHODS

From January 2010 to December 2017, 203 patients were diagnosed as clinical adenocarcinoma (AIS) or minimally invasive adenocarcinoma (MIA) identified on chest computed tomography (CT) and they underwent surgical resection. A retrospective study was performed to analyze the prediction of invasive adenocarcinoma in clinical non- or minimally invasive lung cancer.

RESULTS

Of all clinical AIS or MIA patients, invasive adenocarcinoma was diagnosed in 55 patients (27.1%). In clinical AIS, invasive adenocarcinoma was diagnosed in 19 patients (17.9%) and 36 patients (37.1%) were diagnosed as invasive adenocarcinoma in clinical MIA (P=0.002). Tumor diameter and the presence of solid component were confirmed to be significant predictive factors for invasive adenocarcinoma in a multivariate analysis [hazard ratio (HR) 1.071, P=0.037; HR 2.573, P=0.005; respectively].

CONCLUSIONS

Large tumor size and the presence of solid component in clinical AIS or MIA are predictive factors for invasive adenocarcinoma. Therefore, early surgical intervention is recommended for those lesions.

摘要

背景

纯磨玻璃影（GGO）或伴有小实性成分（≤5mm）的部分实性GGO可能为非侵袭性或微侵袭性肺癌。然而，这些病变有时术后被诊断为侵袭性腺癌。本研究旨在确定临床非侵袭性或微侵袭性肺癌中侵袭性腺癌的预测因素。

方法

2010年1月至2017年12月，203例经胸部计算机断层扫描（CT）诊断为临床腺癌（AIS）或微侵袭性腺癌（MIA）的患者接受了手术切除。进行回顾性研究以分析临床非侵袭性或微侵袭性肺癌中侵袭性腺癌的预测情况。

结果

在所有临床AIS或MIA患者中，55例（27.1%）被诊断为侵袭性腺癌。在临床AIS中，19例（17.9%）被诊断为侵袭性腺癌，在临床MIA中有36例（37.1%）被诊断为侵袭性腺癌（P=0.002）。多因素分析证实肿瘤直径和实性成分的存在是侵袭性腺癌的重要预测因素[风险比（HR）1.071，P=0.037；HR 2.573，P=0.005]。