Identification of Early T1b Lung Adenocarcinoma Based on Thin-Section Computed Tomography Findings
Identification of Early T1b Lung Adenocarcinoma Based on Thin-Section Computed Tomography Findings
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DOI：
10.1097/jto.0b013e31829f6d3b
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发表时间：
2013-10-01
影响因子：
20.4
通讯作者：
Nagai, Kanji
中科院分区：
文献类型：
--
作者：
Aokage, Keiju;Yoshida, Junji;Nagai, Kanji
简介：本研究的目的是放射学识别早期肺腺癌在临床T1 bN 0 M0肺癌，病理结果和长期预后的基础上：方法：在这项研究中，我们回顾了肺结节的薄层CT结果在173例临床T1 bN 0 M0肺腺癌谁在2003年和2007年之间接受手术。计算实性衰减的大小与最大肿瘤尺寸的比率（实变/肿瘤[C/T]比率）。我们将两组患者的C/T比值临界值分别定义为0.00、0.25、0.50、0.75和1.00，并比较两组之间病理性非侵袭性肺腺癌的发生率、总生存率和复发率。比较两组间主要组织学亚型的百分比，按最佳临界水平划分。各种临床因素进行了单因素和多因素分析，以预测病理淋巴结involvement.Results：中位随访时间为62个月。所有C/T比值小于等于0.5的患者均被诊断为病理性非侵袭性腺癌，且无复发;其5年总生存率为97.4%，明显优于C/T比值大于0.5的患者（76.2%）。毛玻璃影为主的肿瘤中没有一个是以粘液为主的实体腺癌。结论：在临床T1 bN 0 M0期肺腺癌患者中，C/T比值≤ 0.5可作为早期肺腺癌的诊断标准。对于已确定的早期疾病患者，可能需要进行有限手术的可行性研究。
Introduction: The aim of this study was to radiologically identify early lung adenocarcinoma in clinical T1bN0M0 lung cancer, based on pathological findings and long-term prognosis.Methods: In this study, we reviewed lung nodules findings on thin-section computed tomography in 173 patients with clinical T1bN0M0 lung adenocarcinoma who underwent surgery between 2003 and 2007. The ratio of the size of solid attenuation to the maximum tumor dimension (consolidation/tumor [C/T] ratio) was calculated. We defined two groups of patients by C/T ratio cutoff levels of 0.00, 0.25, 0.50, 0.75, and 1.00 and compared the rates of pathological nonaggressive lung adenocarcinoma, overall survival, and recurrence rates between the groups. The percentages of predominant histological subtypes were compared between two groups divided by the optimal cutoff level. Various clinical factors were analyzed by univariate and multivariate analyses to predict pathological lymph node involvement.Results: The median follow-up period was 62 months. All patients with C/T ratios of 0.5 or less were diagnosed as having pathological nonaggressive adenocarcinomas, and there was no recurrence; their 5-year overall survival rate was 97.4%, which was significantly better than that for patients with C/T ratios of greater than 0.5 (76.2%). None of the ground-glass opacity-predominant tumors were predominantly solid adenocarcinoma with mucin. The C/T ratio of 0.5 or more was an independent predictor of lymph node involvement.Conclusion: In patients with clinical T1bN0M0 disease, the C/T ratio of 0.5 or less identified early lung adenocarcinoma. In patients with the identified early disease, a feasibility study of limited surgery may be warranted.