Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT
Clinical significance of a solitary ground-glass opacity (GGO) lesion of the lung detected by chest CT
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DOI：
10.1016/j.lungcan.2006.09.009
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发表时间：
2007-01-01
期刊：
影响因子：
5.3
通讯作者：
Lee, Choon-Taek
中科院分区：
文献类型：
--
作者：
Oh, Jin-Young;Kwon, Sung-Youn;Lee, Choon-Taek
毛玻璃样混浊（GGO）由于早期肺癌的可能性而引起人们的关注。然而，一些病变在随访中缩小或消失。本研究旨在探索孤立性 GGO 的自然史，确定恶性肿瘤的患病率并确定良性或恶性肿瘤的预测因素。包括小于 3 cm 的孤立性和局灶性 GGO 病变 [pGGO（p = 纯）和 mGGO（m = 混合），基于固体成分的存在]。小于1厘米的病灶3个月后进行胸部HRCT随访，大于1厘米的病灶进行经皮穿刺活检（PCNB）。共有 186 名患者（69 名 pGGO 和 117 名 mGGO）入组。 69个pGGO病灶中，7个诊断为恶变前或恶性病灶，3个为良性病灶，26个pGGO病灶（37.6%）在随访胸部HRCT时缩小或消失（一过性病灶），其余33个病灶在随访期间未见明显变化。因此，pGGO 发生恶性肿瘤的概率为 7/36 (19.4%)。另一方面，在117个mGGO病灶中，26个被发现为恶性，3个被诊断为良性，57个病灶（48.7%）在后续胸部HRCT中缩小或消失。其余31个病灶随访期间无变化，因此mGGO恶变的概率为26/86（30.2%）。发现女性性别和有刺的 mGGO 边界与恶性肿瘤有关。然而，高血嗜酸性粒细胞计数与消退或短暂性 mGGO 密切相关，表明嗜酸性粒细胞肺部浸润 (PIE) 可能是其原因。我们建议在存在高嗜酸性粒细胞的情况下，对 mGGO 病变进行胸部 HRCT 短期随访 - 较少考虑病变大小。 (c) 2006 Elsevier Ireland Ltd. 保留所有权利。
Ground-glass opacity (GGO) attracts attention because of the possibility of early lung cancer. However, some lesions are reduced in size or disappear at follow-up. This study was designed to explore the natural history of solitary GGO, to determine the prevalence of malignancy and to identify factors predictive of benignity or malignancy. Solitary and focal GGO lesions [pGGO (p = pure) and mGGO (m = mixed) based on the presence of a solid component] of less than 3 cm were included. Lesions of less than 1 cm were followed up by chest HRCT 3 months later and lesions over 1 cm were investigated by percutaneous needle biopsy (PCNB). One hundred and eighty-six patients (69 pGGO and 117 mGGO) were enrolled. Of the 69 pGGO lesions, 7 were diagnosed as pre-malignant or malignant lesions, 3 as benign lesions and 26 pGGO lesions (37.6%) were reduced or disappeared (transient lesions) at follow-up chest HRCT The other 33 lesions showed no significant change during follow-up. Thus, the probability of malignancy in pGGO was 7/36 (19.4%). On the other hand, of the 117 mGGO lesions, 26 were found to be malignant, 3 were diagnosed as benign and 57 lesions (48.7%) were reduced or had disappeared at follow-up chest HRCT. The other 31 lesions showed no change during follow-up, and thus the probability of malignancy in mGGO was 26/86 (30.2%). A female sex and a spiculated mGGO border were found to be related with malignancy. However, a high blood eosinophil count was strongly associated with regressing or transient mGGO, suggesting that pulmonary infiltrate with eosinophilia (PIE) might have been responsible. We recommend short-term follow-up by chest HRCT be conducted for mGGO lesions in the presence of high eosinophilia-regard less of lesion size. (c) 2006 Elsevier Ireland Ltd. All rights reserved.