Department of Thoracic Surgery, Shandong Provincial Hospital, Shandong University, Jinan, China.
Department of Thoracic Surgery, Shandong Provincial Hospital, Jinan, China.
Thorac Cancer. 2023 Dec;14(35):3433-3444. doi: 10.1111/1759-7714.15136. Epub 2023 Oct 24.
The aim of this study was to investigate the imaging features, lymph node metastasis, and genetic mutations in micropapillary lung adenocarcinoma (imaging with mixed ground-glass nodules) ≤2 cm, to provide a more precise and refined basis for the selection of lung segment resection.
A retrospective analysis of 162 patients with surgically resected pathologically confirmed cancers ≤2.0 cm in diameter (50 cases of micropapillary mixed ground-glass nodules [mGGNs], 50 cases of nonmicropapillary mGGNs, and 62 cases of micropapillary SNs [solid nodules]) was performed. mGGNs were classified into five categories according to imaging features. The distribution of these five morphologies in micropapillary with mGGN and nonmicropapillary with mGGN was analyzed. The postoperative pathology and prognosis of lymph node metastasis were also compared between micropapillary mGGNs and micropapillary with SNs. After searching the TCGA database, we demonstrated heterogeneity, high malignancy and high risk of microcapillary lung cancer cancers.
Different pathological subtypes of mGGN differed in morphological features (p < 0.05). The rate of lymph node metastasis was significantly higher in micropapillary mGGNs than in nonmicropapillary mGGNs. In the TCGA database samples, lactate transmembrane protein activity, collagen transcription score, and fibroblast EMT score were remarkably higher in micropapillary adenocarcinoma. Other pathological subtypes had a better survival prognosis and longer disease-free survival compared with micropapillary adenocarcinoma.
mGGNs ≤2 cm with a micropapillary pattern have a higher risk of lymph node metastasis compared with SNs, and computed tomography (CT) imaging features can assist in their diagnosis.
本研究旨在探讨直径≤2cm 的混合磨玻璃结节型微乳头肺腺癌（影像学表现为混合磨玻璃结节）的影像学特征、淋巴结转移及基因突变情况，为肺段切除术的选择提供更精确、更细化的依据。
回顾性分析了 162 例经手术切除病理证实的直径≤2.0cm 的癌症患者（50 例微乳头混合磨玻璃结节[mGGNs]、50 例非微乳头 mGGNs 和 62 例微乳头实性结节[SNs]）。根据影像学特征将 mGGNs 分为五型，分析微乳头 mGGN 和非微乳头 mGGN 中这五种形态的分布情况。比较微乳头 mGGN 和微乳头 SNs 之间术后淋巴结转移的病理和预后。通过 TCGA 数据库检索，展示微乳头肺癌的异质性、高恶性度和高风险。
不同形态学亚型的 mGGN 在形态特征上存在差异（p<0.05）。微乳头 mGGN 的淋巴结转移率显著高于非微乳头 mGGN。在 TCGA 数据库样本中，微乳头腺癌的乳酸跨膜蛋白活性、胶原转录评分和成纤维细胞 EMT 评分显著更高。其他病理亚型的生存预后和无病生存时间均优于微乳头腺癌。
直径≤2cm 的微乳头 mGGN 与 SNs 相比具有更高的淋巴结转移风险，CT 影像学特征有助于其诊断。
