Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection
Lung cancer patients showing pure ground-glass opacity on computed tomography are good candidates for wedge resection
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DOI：
10.1016/j.lungcan.2003.09.025
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发表时间：
2004-04-01
期刊：
影响因子：
5.3
通讯作者：
Kato, H
中科院分区：
文献类型：
--
作者：
Nakamura, H;Saji, H;Kato, H
近年来，在通过计算机断层扫描（CT）进行的大规模筛查中经常发现小肺癌。对于这些小肺癌，有限切除术的适用性仍然存在争议。方法回顾性分析1981 ~ 2002年我院100例肺癌行小叶下局限性切除术（楔形切除或肺段切除）的临床资料。根据CT表现，肿瘤分为两组：纯磨玻璃样阴影（PGGO）和非PGGO。患者包括44名女性和56名男性，年龄范围为40至92岁（平均71.0岁）。组织学类型包括76例腺癌、21例鳞状细胞癌和3例大细胞癌。临床分期IA期83例，IB期17例。通过高分辨率CT，27个肿瘤（27%）显示PGGO;在术后组织病理学检查，所有这些都是局限性细支气管肺泡癌。显示PGGO的肿瘤直径为9.3 ± 3.5 mm（平均值± S.D.）;非PGGO肿瘤的5年生存率为21.2 ± 13.7 mm。所有患者的总体和肺癌特异性5年生存率分别为58.0%和64.8%。小腺癌（≤ 20 mm）的5年生存率为93.7%，明显高于大腺癌的24.8%（P < 0.0001）。在PGGO肿瘤中没有观察到胸内复发或远处转移。对于表现为PGGO的周围型局限性细支气管肺泡癌，楔形切除术似乎是最好的手术方式。需要更多患者的连续性研究和更长的随访时间。(C)2003爱思唯尔爱尔兰有限公司保留所有权利。
Small lung cancers frequently have been detected in mass screening by computed tomography (CT) in recent years. Suitability of limited resection for these small lung cancers remains controversial. One hundred patients who underwent sublobular limited resection (wedge resection or segmentectomy) for lung cancer in our hospital from 1981 to 2002 were analyzed retrospectively. From CT findings, tumors were classified into two groups; pure ground-glass opacity (PGGO) and non-PGGO. Patients included 44 women and 56 men, and ages ranged from 40 to 92 years (mean, 71.0). Histologic types included 76 adenocarcinomas, 21 squamous cell carcinomas, and 3 large cell carcinomas. Clinical stages included 83 stage IA and 17 stage IB. By high-resolution CT, 27 tumors (27%) showed PGGO; at postoperative histopathologic examination, all of these were localized bronchioloalveolar carcinomas. Diameter of tumors showing PGGO was 9.3 +/- 3.5 mm (mean +/- S.D.); that of non-PGGO tumors was 21.2 +/- 13.7 mm. Overall and lung cancer-specific 5-year survival rates in all patients were 58.0 and 64.8%, respectively. Overall 5-year survival rate with small adenocarcinomas (less than or equal to20mm) was 93.7%, significantly better than 24.8% with Larger adenocarcinomas (P < 0.0001). No intrathoracic recurrence or distant metastasis has been observed in PGGO tumors. For peripheral Localized bronchioloalveolar carcinoma showing PGGO, wedge resection appears to be the best operation. Definitive study of more patients with longer follow-up is needed. (C) 2003 Elsevier Ireland Ltd. All rights reserved.