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经病理确诊结节的临床特征及治疗结果

Clinical Characteristics and Treatment Outcomes of Pathologically Confirmed Nodules.

作者信息

Kang Noeul, Park Jiyeon, Jhun Byung Woo

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.

出版信息

J Clin Med. 2020 Jul 10;9(7):2185. doi: 10.3390/jcm9072185.

Abstract

nodules represent a subtype of chronic pulmonary aspergillosis, but details on their characteristics and outcomes are limited. We evaluated 80 patients with pathologically confirmed nodules between January 2009 and December 2016. The median age of the patients was 59 years, and 46 (58%) were women. Seventy-three (91%) patients were surgically diagnosed with nodules and the remaining seven (9%) patients were diagnosed by percutaneous transthoracic needle biopsy. The median long-axis diameter of nodules was 22 mm, and nodules had an internal cavity in 49 (61%) patients. Spiculation and calcification were observed in 20% and 39% of patients, respectively. Ninety percent (18/20) of nodules showed uptake on positron emission tomography. Serum precipitin IgG antibody was positive in 42% (10/24) of tested patients. Seventy-three (91%) patients underwent surgery without ( = 58) or with ( = 15) adjuvant antifungal therapy, and the remaining seven (9%) patients received antifungal therapy alone ( = 5) or no treatment ( = 2). Three patients experienced postoperative pulmonary complications: pneumothorax, hemoptysis, and acute lung injury ( = 1 each). There was no recurrence during the median follow-up period of 36.8 months. In conclusion, surgery could be a treatment strategy worth considering for most nodules. However, given that our study population was heterogeneous, further well-designed studies are need.

摘要

结节是慢性肺曲霉病的一种亚型,但其特征和转归的细节有限。我们评估了2009年1月至2016年12月期间80例经病理证实的结节患者。患者的中位年龄为59岁,46例(58%)为女性。73例(91%)患者经手术诊断为结节,其余7例(9%)患者通过经皮经胸针吸活检确诊。结节的中位长轴直径为22mm,49例(61%)患者的结节有内部空洞。分别有20%和39%的患者观察到毛刺征和钙化。90%(18/20)的结节在正电子发射断层扫描上有摄取。42%(10/24)的受试患者血清沉淀素IgG抗体呈阳性。73例(91%)患者接受了手术,其中58例未接受或15例接受了辅助抗真菌治疗,其余7例(9%)患者单独接受抗真菌治疗(5例)或未接受治疗(2例)。3例患者出现术后肺部并发症:气胸、咯血和急性肺损伤(各1例)。在36.8个月的中位随访期内无复发。总之,手术可能是大多数结节值得考虑的一种治疗策略。然而,鉴于我们的研究人群具有异质性,需要进一步设计良好的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0849/7408717/ae4a2dee409c/jcm-09-02185-g001.jpg

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