Ground-glass opacity lesions on computed tomography during postoperative surveillance for primary non-small cell lung cancer
Ground-glass opacity lesions on computed tomography during postoperative surveillance for primary non-small cell lung cancer
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DOI：
10.1016/j.lungcan.2011.09.002
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发表时间：
2012-04-01
期刊：
影响因子：
5.3
通讯作者：
Maehara, Yoshihiko
中科院分区：
文献类型：
--
作者：
Haro, Akira;Yano, Tokujiro;Maehara, Yoshihiko
胸部高分辨率计算机断层扫描 (CT) 的改进提高了毛玻璃样不透明 (GGO) 病变的检出率。然而，对于原发性肺癌治疗后术后随访胸部CT中发现的并发GGO病变，目前尚无明确的治疗共识。本研究回顾性和前瞻性地调查了2009年4月至2010年2月在九州大学医院非小细胞肺癌术后随访CT中发现53个GGO病灶的21例患者。我们调查了临床病理因素，如年龄、性别、病灶数量、大小、偏侧性、识别时间以及内部实性成分的扩大或出现。通过Kaplan-Meier曲线的对数秩检验评估并发GGO病变的恶性率。 53 个 GGO 病变中，有 20% 在首次通过 CT 发现后的 5 年随访期间出现恶性放射学发现。术后 CT 中新出现的 GGO 病变的放射学表现（39.5%）明显高于其他 GGO 病变（9.5%）。三个潜在恶性 GGO 病变通过手术切除进行治疗，另外三个则通过立体定向放射治疗进行治疗。这6个治疗后的GGO病变表现出良好的临床病程，治疗后没有复发。应特别关注原发性非小细胞肺癌切除后新出现的 GGO 病变。需综合考虑GGO病灶的偏侧性、数量或术后肺癌的病理分期等多种因素，选择合适的治疗方法。 (C) 2011 Elsevier Ireland Ltd. 保留所有权利。
Improvement in chest high-resolution computed tomography (CT) has increased the detection of ground-glass opacity (GGO) lesions. However, there is no clear therapeutic consensus about concurrent GGO lesions detected during postoperative follow-up chest CT after treatment for primary lung cancer. This study retrospectively and prospectively investigated 21 patients in whom 53 GGO lesions were detected during postoperative follow-up CT of non-small cell lung cancer at Kyushu University Hospital from April 2009 to February 2010. We investigated clinicopathological factors, such as age, gender, lesion number, size, laterality, time of identification, and enlargement or emergence of the inner solid component. The malignancy rate of the concurrent GGO lesions was assessed by log-rank test in the Kaplan-Meier curves. Twenty percent of the 53 GGO lesions had malignant radiological findings during the 5-year follow-up after they were first identified by CT. The newly emerging GGO lesions at postoperative CT had significantly more malignant radiological findings (39.5%) than other GGO lesions (9.5%). Three potentially malignant GGO lesions were treated by surgical resection and three were treated by stereotactic radiotherapy. These six treated GGO lesions showed a good clinical course without recurrence after treatment. Special attention should be paid to newly emerging GGO lesions after resection of primary non-small cell lung cancer. It is necessary to select an appropriate treatment, taking account of various factors such as the laterality and number of GGO lesions or the pathological stage of the postoperative lung cancer. (C) 2011 Elsevier Ireland Ltd. All rights reserved.