Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography
Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography
复制标题
高分辨率计算机断层扫描孤立性磨玻璃样肺结节的临床、病理和放射学特征
DOI：
10.2147/tcrm.s110363
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Li, Wei-Min
中科院分区：
文献类型：
--
作者：
Qiu, Zhi-Xin;Cheng, Yue;Li, Wei-Min
背景随着高分辨率计算机断层扫描（HRCT）的广泛应用，肺结节的检出率逐年上升。毛玻璃样结节是一种特殊类型的肺结节，已被证实与早期肺癌密切相关。目前对孤立性毛玻璃样结节（SGGN）知之甚少。在本研究中，我们分析了SGGN的临床、病理和HRCT影像学特征。方法对95例手术切除的SGGN行HRCT扫描。分析其临床、病理及影像学特点。结果81例腺癌和14例良性结节。结节包括12例（15%）原位腺癌（AIS）、14例（17%）微创腺癌（MIA）和55例（68%）浸润腺癌（IA）。迄今为止，尚未发现复发患者。间变性淋巴瘤激酶和原癌基因酪氨酸蛋白激酶ROS-1的阳性表达率分别为2.5%和8.6%。HRCT诊断浸润性肺腺癌的特异性和准确性分别为85.2%和87.4%。仅2例患者的标准摄取值由18F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）确定高于2.5。结节的大小、密度、形状和胸膜标记是鉴别IA与AIS和MIA的重要因素。结节的大小、形态、边缘、胸膜标记、血管簇、气泡样征、支气管充气征是决定混合性磨玻璃样结节的重要因素（P均<0.05）。结论分析SGGN的临床、病理及HRCT影像学特征，发现SGGN的大小、密度、形态及胸膜标记是IA的决定性因素。总之，不建议常规检测间变性淋巴瘤激酶表达和进行PET/CT扫描。
Background Lung nodules are being detected at an increasing rate year by year with high-resolution computed tomography (HRCT) being widely used. Ground-glass opacity nodule is one of the special types of pulmonary nodules that is confirmed to be closely associated with early stage of lung cancer. Very little is known about solitary ground-glass opacity nodules (SGGNs). In this study, we analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT. Methods A total of 95 resected SGGNs were evaluated with HRCT scan. The clinical, pathological, and radiological characteristics of these cases were analyzed. Results Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarcinoma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (all P<0.05). Conclusion We analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT and found that the size, density, shape, and pleural tag of SGGNs on HRCT are found to be the determinant factors of IA. In conclusion, detection of anaplastic lymphoma kinase expression and performance of PET/CT scan are not routinely recommended.