Progression of focal pure ground-glass opacity detected by low-dose helical computed tomography screening for lung cancer
Progression of focal pure ground-glass opacity detected by low-dose helical computed tomography screening for lung cancer
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DOI：
10.1097/00004728-200401000-00003
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发表时间：
2004-01-01
影响因子：
1.3
通讯作者：
Moriyama, N
中科院分区：
文献类型：
--
作者：
Kakinuma, R;Ohmatsu, H;Moriyama, N
目的：为了阐明肺癌低剂量螺旋CT筛查发现的局灶性纯磨玻璃样阴影（pGGO）的进展，方法：共进行了15,938次低剂量螺旋CT检查，在2052名参与者的筛查项目，其中1566人被判定为有异常结果，需要进一步检查。在第一次薄层CT检查时表现出pGGO并在随访超过6个月后通过薄层CT进行组织学证实的外周结节患者入组本研究。结果：8例患者的肿瘤进展分为3种类型：肿瘤体积增大型、肿瘤大小增大型、肿瘤大小增大型（n = 5：细支气管肺泡癌[BAC]），大小减小，出现固体成分（n = 2：BAC，n = 1;腺癌与混合亚型[Ad]，n=1），和稳定的大小和密度增加（n = 1：BAC）。此外，体积减小组进一步分为2个亚型：快速减小型（Ad：n = 1）和缓慢减小型（BAC：n = 1）。第一次薄层CT检查与手术之间的平均时间为18个月（范围：7-38个月）。除了一个肺癌的后续病例是非侵入性的，而其余的GGO与固体成分是微创的。结论：肺癌结节的pGlycine不仅在大小或密度增加，但也可能会迅速或缓慢地减少与固体成分的外观。密切随访直至出现固体成分可能是治疗pGGO的有效选择。
Objective: To clarify the progression of focal pure ground-glass opacity (pGGO) detected by low-dose helical computed tomography (CT) screening for lung cancer.Methods: A total of 15,938 low-dose helical CT examinations were performed in 2052 participants in the screening project, and 1566 of them were judged to have yielded abnormal findings requiring further examination. Patients with peripheral nodules exhibiting pGGO at the time of the first thin-section CT examination and confirmed histologically by thin-section CT after follow-up of more than 6 months were enrolled in the current study. Progression was classified based on the follow-up thin-section CT findings.Results: The progression of the 8 cases was classified into 3 types: increasing size (n = 5: bronchioloalveolar carcinoma [BAC]), decreasing size and the appearance of a solid component (n = 2: BAC, n = 1; adenocarcinoma with mixed subtype [Ad], n=1), and stable size and increasing density (n = 1: BAC). In addition, the decreasing size group was further divided into 2 subtypes: a rapid-decreasing type (Ad: n = 1) and a slow-decreasing type (BAC: n = 1). The mean period between the first thin-section CT and surgery was 18 months (range: 7-38 months). All but one of the follow-up cases of lung cancer were noninvasive whereas the remaining GGO with a solid component was minimally invasive.Conclusions: The pGGOs of lung cancer nodules do not only increase in size or density, but may also decrease rapidly or slowly with the appearance of solid components. Close follow-up until the appearance of a solid component may be a valid option for the management of pGGO.