Department of Surgical oncology, Hiroshima University Hospital, Hiroshima, Japan.
Jpn J Clin Oncol. 2020 Oct 22;50(11):1306-1312. doi: 10.1093/jjco/hyaa167.
This study aimed to determine the characteristics, ground glass opacity ratio and prognosis of patients with clinical N0 non-small cell lung cancer tumours exceeding 30 mm in size.
Patients with clinical N0 non-small cell lung cancer and total tumour size >30 mm on preoperative computed tomography who underwent complete resection with lobectomy between January 2007 and December 2017 were included. The patients were divided into three groups: pure solid tumour, low ground glass opacity ratio (1-39%) tumour and high ground glass opacity ratio (≥40%) tumour. The cut-off line was determined based on the recurrence rate for every 10% ground glass opacity ratio.
Among the 227 study patients, 129 (56.8%) had a pure solid tumour, 54 (23.8%) had a low ground glass opacity ratio tumour and 44 (19.4%) had a high ground glass opacity ratio tumour. Three-year recurrence-free survival was significantly shorter in patients with a pure solid tumour (57.4%) than in patients with a low ground glass opacity ratio (74.5%; P = 0.009) or a high ground glass opacity ratio tumour (92.1%; P < 0.001). Multivariable analysis showed that ground glass opacity ratio was a significant independent prognostic factor for recurrence-free survival (hazard ratio, 0.175; P = 0.037).
Pure solid tumours comprised a large proportion of non-small cell lung cancer tumours >30 mm in size and their prognosis was poor. The presence of ground glass opacity and their relative proportion affect prognosis in patients with clinical N0 non-small cell lung cancer tumours >30 mm in size, similar to those with small-sized tumours.
本研究旨在确定肿瘤最大径＞30mm 的临床 N0 非小细胞肺癌患者的特征、磨玻璃密度比（GGO 比率）及预后。
纳入 2007 年 1 月至 2017 年 12 月行完全性肺叶切除术的术前 CT 示肿瘤最大径＞30mm 的临床 N0 非小细胞肺癌患者，根据肿瘤组织是否全部为实性成分，分为纯实性肿瘤、GGO 比率低（1%-39%）肿瘤及 GGO 比率高（≥40%）肿瘤三组。以每 10%GGO 比率为间隔，绘制 GGO 比率与复发率的关系曲线，确定复发风险转折点。
227 例患者中，纯实性肿瘤 129 例（56.8%），GGO 比率低肿瘤 54 例（23.8%），GGO 比率高肿瘤 44 例（19.4%）。纯实性肿瘤组患者 3 年无复发生存率（57.4%）显著低于 GGO 比率低肿瘤组（74.5%，P=0.009）及 GGO 比率高肿瘤组（92.1%，P＜0.001）。多因素分析显示，GGO 比率是无复发生存的独立预后因素（风险比 0.175，P=0.037）。
肿瘤最大径＞30mm 的非小细胞肺癌患者中，纯实性肿瘤占较大比例，且预后不良。GGO 存在及其相对比例影响临床 N0 非小细胞肺癌肿瘤最大径＞30mm 患者的预后，与肿瘤较小者相似。
