Division of Pulmonary and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
J Thorac Oncol. 2019 Aug;14(8):1370-1377. doi: 10.1016/j.jtho.2019.05.005. Epub 2019 May 11.
Small ground-glass nodules (GGNs) or those with an indeterminate risk on low-dose computed tomography (LDCT) of the chest are recommended at 5-year follow-up, but the rationale for follow-up beyond 5 years is unclear.
An observational study was conducted to investigate the natural course of GGNs that had been stable for 5 years by LDCT over 10 years. All eligible GGNs were detected during regular health checkups. Baseline characteristics were compared between GGNs with and without growth. Risk factors for GGN growth were evaluated.
A total of 208 GGNs were detected in 160 participants. GGN growth was identified in 27 (13.0%) GGNs during a follow-up of 136 months on LDCT scans. In approximately 95% of these GGNs, the initial size was less than 6 mm, with 3.2 mm of growth over 8.5 years. Biopsies were performed in 3 of 27 GGNs, revealing adenocarcinoma. In 8 of 27 cases, GGN growth preceded the development of a new solid component. In a multivariate analysis, bubble lucency (p = 0.001), a history of cancer other than lung cancer (p = 0.036), and development of a new solid component (p < 0.001) were significant risk factors for GGN growth.
GGNs should not be ignored, even when smaller than 6 mm and stable for 5 years, especially when a new solid component appears during follow-up.
胸部低剂量计算机断层扫描（LDCT）显示的小磨玻璃结节（GGN）或具有不确定风险的 GGN 建议在 5 年后进行随访，但 5 年后随访的依据尚不清楚。
本观察性研究旨在通过 10 年 LDCT 对稳定 5 年的 GGN 进行自然病程研究。所有符合条件的 GGN 均在常规健康检查中发现。比较 GGN 生长和不生长之间的基线特征。评估 GGN 生长的危险因素。
160 名参与者共检测到 208 个 GGN。在 LDCT 扫描的 136 个月随访中，有 27 个（13.0%）GGN 发现生长。在这些 GGN 中，约 95%的初始大小小于 6mm，8.5 年内生长了 3.2mm。对 27 个 GGN 中的 3 个进行了活检，发现了腺癌。在 27 例中有 8 例，GGN 生长先于新实性成分的出现。多变量分析显示，泡状透亮（p=0.001）、除肺癌以外的癌症病史（p=0.036）和新实性成分的出现（p<0.001）是 GGN 生长的显著危险因素。
即使小于 6mm 且稳定 5 年，也不应忽视 GGN，尤其是在随访期间出现新的实性成分时。
