Division of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Surg Today. 2021 Jul;51(7):1188-1202. doi: 10.1007/s00595-021-02235-3. Epub 2021 Mar 20.
To investigate the prognostic implications and pathological features of clinical stage I lung adenocarcinoma with ground-glass opacity (GGO) on computed tomography (CT).
The subjects of this retrospective study were 1228 patients with lung adenocarcinoma classified as clinical stage I, who underwent complete resection by lobectomy. The patients were divided into four groups based on the presence and proportion of GGO according to the consolidation-to-tumor ratio (CTR); A, CTR ≤ 0.5; B, 0.5 < CTR ≤ 0.75; C, 0.75 < CTR ≤ 1.0 with GGO; D, without GGO (pure-solid). We compared overall survival, pathological findings (N/ly/v/STAS), and histological subtypes within each clinical stage among the four groups.
We found no significant differences among tumors with GGO (groups A, B and C) for prognosis or pathological findings in all the clinical stages. The prognoses of groups A, B and C were significantly better than that of group D for patients with clinical stages IA2-IB disease. Tumors without GGO on CT had a significantly larger number of positive N, ly, v and STAS in almost all stages than tumors with GGO on CT. Tumors without GGO on CT had significantly more solid predominant and less lepidic predominant adenocarcinoma.
Not the proportion of GGO, but its presence on CT, as well as the size of the solid component, were correlated significantly with pathological characteristics and survival.
研究 CT 显示磨玻璃密度（GGO）的临床Ⅰ期肺腺癌的预后意义和病理特征。
本回顾性研究的对象为 1228 例经肺叶切除术完全切除的临床Ⅰ期肺腺癌患者。根据肿瘤实性成分与 GGO 比值（CTR）将患者分为 4 组：A 组，CTR≤0.5；B 组，0.5<CTR≤0.75；C 组，0.75<CTR≤1.0 伴 GGO；D 组，无 GGO（纯实性）。比较四组患者的总生存率、病理发现（N/ly/v/STAS）以及各临床分期的组织学亚型。
在所有临床分期中，GGO 组（A、B 和 C 组）之间在预后或病理发现方面均无显著差异。对于临床分期为 IA2-IB 期的患者，A、B 和 C 组的预后明显优于 D 组。CT 上无 GGO 的肿瘤在几乎所有分期中 N、ly、v 和 STAS 的阳性率均显著高于 CT 上有 GGO 的肿瘤。CT 上无 GGO 的肿瘤具有更多的实性为主型和更少的贴壁为主型腺癌。
不是 GGO 的比例，而是 CT 上 GGO 的存在以及实性成分的大小与病理特征和生存显著相关。
