Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea.
Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, South Korea.
Interact Cardiovasc Thorac Surg. 2022 Jan 18;34(2):229-235. doi: 10.1093/icvts/ivab257.
The current understanding of pulmonary invasive mucinous adenocarcinoma is largely based on studies of advanced stage patients and data about early-stage invasive mucinous adenocarcinoma are sparse. We evaluated the radiological and clinical features of screening-detected early-stage invasive mucinous adenocarcinoma (SD-IMA).
Data from 91 patients who underwent surgical treatment for SD-IMA (≤3 cm) from 2013 to 2019 were reviewed retrospectively. Data on radiological characteristics, clinicopathological findings, recurrence and survival were obtained. Disease-free survival rate was analysed.
Radiologically, SD-IMAs presented as a pure ground-glass nodule (6.6%), part-solid nodule (38.5%) or solid (54.9%). Dominant locations were both lower lobes (74.7%) and peripheral area (93.4%). The sensitivity of percutaneous needle biopsy was 78.1% (25/32). Lobectomy was performed in 70 (76.9%) patients, and sublobar resection in 21 (23.1%) patients. Seventy-three (80.2%), 15 (16.5%) and 3 (3.3%) patients had pathological stage IA, IB and IIB or above, respectively. Seven patients developed recurrence, and 3 died due to disease progression. Pleural seeding developed exclusively in 2 patients who underwent needle biopsy. The 5-year disease-free survival rate was 89.4%. The disease-free survival rates at 5 years were 86.3% in the lobectomy group and 100% in the sublobar resection group.
SD-IMAs were mostly radiologically invasive nodules. SD-IMAs showed favourable prognosis after surgical treatment.
目前对肺浸润性黏液腺癌的认识在很大程度上基于对晚期患者的研究，而早期浸润性黏液腺癌的数据则很少。我们评估了筛查发现的早期浸润性黏液腺癌（SD-IMA）的影像学和临床特征。
回顾性分析了 2013 年至 2019 年间 91 例接受手术治疗的 SD-IMA（≤3cm）患者的数据。收集了影像学特征、临床病理资料、复发和生存情况。分析无病生存率。
SD-IMA 影像学表现为纯磨玻璃结节（6.6%）、部分实性结节（38.5%）或实性结节（54.9%）。主要位于下叶（74.7%）和外周区域（93.4%）。经皮穿刺活检的敏感性为 78.1%（25/32）。70 例（76.9%）患者行肺叶切除术，21 例（23.1%）患者行亚肺叶切除术。73 例（80.2%）、15 例（16.5%）和 3 例（3.3%）患者的病理分期分别为 IA、IB 和 IIB 期及以上。7 例患者复发，3 例患者因疾病进展死亡。仅 2 例经皮穿刺活检患者发生胸膜播散。5 年无病生存率为 89.4%。肺叶切除术组 5 年无病生存率为 86.3%，亚肺叶切除术组为 100%。
SD-IMA 大多为影像学侵袭性结节。SD-IMA 经手术治疗后预后良好。
