Wang Jun, Ma Han, Ni Chong-Jun, He Jing-Kang, Ma Hai-Tao, Ge Jin-Feng
Department of Thoracic Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Department of Respiratory Medicine, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
J Thorac Dis. 2019 Feb;11(2):557-563. doi: 10.21037/jtd.2019.01.32.
The detection rate of ground-glass opacity (GGO) in young patients has increased year by year with the increasingly widespread use of high-resolution computed tomography (HRCT) and the increased resolution of HRCT imaging. However, no scholars have reported the clinical characteristics and prognosis of GGO in young patients systematically. The purpose of this study is to investigate the clinical characteristics and prognosis presenting as GGO in young patients.
Clinical data of 127 young patients who were diagnosed as GGO and who underwent video-assisted thoracoscopic surgery (VATS) and had routine pathological examination were collected from January 2016 to January 2017. Nodules were classified according to benign and malignant: 26 benign nodules (Group A) and 115 malignant nodules (Group B). The pathological types, nodules size, surgical methods were analyzed, and the clinical characteristics and prognosis were evaluated.
The results of pathological examination of 91 pure ground-glass opacities (pGGOs) revealed 16 adenocarcinoma in situs (AISs), 42 micro invasive adenocarcinomas (MIAs), 13 invasive adenocarcinomas (IAs), 8 atypical adenomatous hyperplasias (AAHs), 1 inflammatory granuloma, 2 pulmonary inflammatory pseudotumors (IPTs) and 9 other benign nodules. The results of pathological examination of 50 mixed ground-glass opacities (mGGOs) revealed 6 AISs, 29 MIAs, 9 IAs, 1 AAH, 2 inflammatory granulomas and 3 other benign nodules. All patients had no lymph nodes invasion. The rates of perioperative complications were 6.30%, compared to 7.63% for long-term complications. None of the patients with GGO experienced a recurrence and death [2-year recurrence-free survival (RFS), 100%; 2-year overall survival (OS), 100%].
The GGO in young patients that received VATS has a high proportion of malignant, its prognosis is satisfied.
随着高分辨率计算机断层扫描(HRCT)的日益广泛应用以及HRCT成像分辨率的提高,年轻患者中磨玻璃影(GGO)的检出率逐年上升。然而,尚无学者系统报道年轻患者GGO的临床特征及预后情况。本研究旨在探讨以GGO形式出现的年轻患者的临床特征及预后。
收集2016年1月至2017年1月期间127例经诊断为GGO并接受电视辅助胸腔镜手术(VATS)及常规病理检查的年轻患者的临床资料。结节根据良恶性分类:26个良性结节(A组)和115个恶性结节(B组)。分析病理类型、结节大小、手术方式,并评估临床特征及预后。
91个纯磨玻璃影(pGGO)的病理检查结果显示,原位腺癌(AIS)16例,微浸润腺癌(MIA)42例,浸润性腺癌(IA)13例,非典型腺瘤样增生(AAH)8例,炎性肉芽肿1例,肺炎性假瘤(IPT)2例,其他良性结节9例。50个混合磨玻璃影(mGGO)的病理检查结果显示,AIS 6例,MIA 29例,IA 9例,AAH 1例,炎性肉芽肿2例,其他良性结节3例。所有患者均无淋巴结转移。围手术期并发症发生率为6.30%,长期并发症发生率为7.63%。GGO患者均未出现复发及死亡情况[2年无复发生存率(RFS)为100%;2年总生存率(OS)为100%]。
接受VATS的年轻患者GGO中恶性比例较高,其预后良好。