老年肺部磨玻璃影患者的影像学特征及术后病理分析

doi:10.3969/j.issn.1006-7795.2022.04.007

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 552-557.doi: 10.3969/j.issn.1006-7795.2022.04.007

• 肺癌一体化诊断和治疗 • 上一篇下一篇

老年肺部磨玻璃影患者的影像学特征及术后病理分析

苏雷^1*, 张毅¹, 高艳², 魏兵³, 李元博¹, 王腾腾¹, 钱坤¹, 王雷明⁴

1.首都医科大学宣武医院胸外科, 北京 100053;
2.首都医科大学宣武医院放射科,北京 100053;
3.首都医科大学宣武医院呼吸暨危重症科,北京 100053;
4.首都医科大学宣武医院病理科, 北京 100053

收稿日期:2022-04-13 出版日期:2022-08-21 发布日期:2022-10-28
基金资助:
973国家科技计划项目(2011CB510100)。

Postoperative pathological analysis of elderly pulmonary ground-glass opacity

Su Lei^1*, Zhang Yi¹, Gao Yan², Wei Bing³, Li Yuanbo¹, Wang Tengteng¹, Qian Kun¹, Wang Leiming⁴

1. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
3. Department of Pulmonary and Critical Care Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
4. Department of Pathology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Received:2022-04-13 Online:2022-08-21 Published:2022-10-28
Contact: *E-mail:sulei@xwh.ccmu.edu.cn
Supported by:
This study was supported by National Basic Research Program of China(2011CB510100).

摘要/Abstract

摘要： 目的分析老年肺部磨玻璃影(ground-glass opacity, GGO)患者的影像学特征及病理结果。方法对首都医科大学宣武医院2017年1月至2019年12月手术治疗的281例年龄大于60岁的老年GGO患者的影像学表现和术后病理结果进行回顾性研究。结果 GGO最大径均值为(13.3±7.5)mm。Ⅰ型GGO病例97例(34.5%),Ⅱ型GGO病例119例(42.3%),Ⅲ型和Ⅳ型病例分别为51例(18.1%)和14例(5.0%)。术后病理报告:30例(10.7%)为良性病变,75例(26.7%)浸润前期病变,65例(23.1%)微浸润腺癌,111例(39.5%)浸润期肺癌。对GGO影像学特征与术后病理结果的相关性分析表明,依据GGO影像学特征所进行的GGO分型与术后病理结果存在显著相关性(r=0.365,P＜0.01);GGO分型与肺癌病理亚型存在可能的关联(P<0.05,r=0.276),且与肺癌发生STAS(P<0.05,r=0.175)和胸膜浸润(P<0.01,r=0.236)存在显著相关性。结论老年患者的GGO影像学分型与术后肿瘤性质、肿瘤细胞的浸润程度密切相关。

关键词: 老年患者, 磨玻璃影, 单孔胸腔镜, 术后病理

Abstract: Objective Analyze the imaging manifestations and pathological results of elderly patients with pulmonary ground-glass opacity (GGO). Methods The imaging findings and postoperative pathological findings of 281 GGO patients aged over 60 years who underwent surgical treatment in our hospital from January 2017 to December 2019 were retrospectively studied. Results The mean maximum diameter of GGO was (13.3±7.5)mm. There were 97 cases (34.5%) of GGO type I, 119 cases (42.3%) of GGO type Ⅱ, 51 cases (18.1%) of GGO type Ⅲ and 14 cases (5.0%) of GGO type IV. The mean observation time was (13.5±23.3) months. In the postoperative pathological report, there were 30 cases (10.7%) of benign lesions, 75 cases (26.7%) of preinvasive lesions, 65 cases (23.1%) of minimally invasive adenocarcinoma(MIA), and 111 cases (39.5%) of invasive adenocarcinoma(IA). The correlation analysis of GGO imaging features and postoperative pathological results showed that there was a significant correlation between GGO classification based on GGO imaging features and postoperative pathological results (r=0.365, P<0.01). GGO classification was possibly correlated with pathological subtypes of lung cancer (P<0.05, r=0.276), and significantly correlated with STAS (P<0.05, r=0.175) and pleural infiltration (P<0.01, r=0.236). Conclusion The GGO imaging classification in elderly patients is more closely related to postoperative tumor properties and tumor invasive degree.

Key words: elderly patients, ground-glass opacity, single-hole thoracoscopy, postoperative pathological

中图分类号:

R655.3

苏雷, 张毅, 高艳, 魏兵, 李元博, 王腾腾, 钱坤, 王雷明. 老年肺部磨玻璃影患者的影像学特征及术后病理分析[J]. 首都医科大学学报, 2022, 43(4): 552-557.

Su Lei, Zhang Yi, Gao Yan, Wei Bing, Li Yuanbo, Wang Tengteng, Qian Kun, Wang Leiming. Postoperative pathological analysis of elderly pulmonary ground-glass opacity[J]. Journal of Capital Medical University, 2022, 43(4): 552-557.

参考文献

[1] Bak S H, Lee H Y, Kim J H, et al. Quantitative CT scanning analysis of pure ground-glass opacity nodules predicts further CT scanning change[J]. Chest, 2016, 149(1):180－191.
[2] 苏雷, 张毅, 李元博, 等. 20～30 mm磨玻璃肺结节的影像学特征及术后病理分析[J]. 医学研究杂志, 2020, 49(11):54－59.
[3] Su L, Li Y B, Wang T T, et al. Synchronous multiple primary lung cancers with shared EGFR mutation but differential imaging findings and pathological subtypes: a case report[J]. Respir Med Case Rep, 2020, 31: 101244.
[4] Sawada S, Yamashita N, Sugimoto R, et al. Long-term outcomes of patients with ground-glass opacities detected using CT scanning[J]. Chest, 2017, 151(2):308－315.
[5] Okami J. Treatment strategy and decision-making for elderly surgical candidates with early lung cancer[J]. J Thorac Dis, 2019, 11(Suppl 7):S987－S997.
[6] Zaatar M, Stork T, Valdivia D, et al. Minimal-invasive approach reduces cardiopulmonary complications in elderly after lung cancer surgery[J]. J Thorac Dis, 2020, 12(5):2372－2379.
[7] 苏雷, 支修益, 张毅, 等. 亚厘米肺结节的外科诊疗分析[J]. 中国微创外科杂志, 2017, 17(1):11－14.
[8] Pagès P B, Mariet A S, Madelaine L, et al. Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians[J]. J Thorac Cardiovasc Surg, 2019, 157(4):1660－1667.
[9] Scarci M, Crisci R, Minervini F. Lung surgery in elderly patients: are we doing enough?[J]. J Thorac Dis, 2018, 10(2):693－694.
[10] Kakinuma R, Noguchi M, Ashizawa K, et al. Natural history of pulmonary subsolid nodules: a prospective multicenter study[J]. J Thorac Oncol, 2016, 11(7):1012－1028.
[11] Tutic-Horn M, Gambazzi F, Rocco G, et al. Curative resection for lung cancer in octogenarians is justified[J]. J Thorac Dis, 2017, 9(2):296－302.
[12] Suzuki S, Sakurai H, Yotsukura M, et al. Clinical features of ground glass opacity-dominant lung cancer exceeding 3.0 cm in the whole tumor size[J]. Ann Thorac Surg, 2018, 105(5):1499－1506.
[13] Kadota K, Nitadori J I, Sima C S, et al. Tumor spread through air spaces is an important pattern of invasion and impacts the frequency and location of recurrences after limited resection for small stage I lung adenocarcinomas[J]. J Thorac Oncol, 2015, 10(5):806－814.
[14] Kuhn E, Morbini P, Cancellieri A, et al. Adenocarcinoma classification: patterns and prognosis[J]. Pathologica, 2018, 110(1):5－11.
[15] Huang C C, Wang C, Wang Y D, et al. The prognostic significance of pure ground glass opacities in lung cancer computed tomographic images[J]. J Cancer, 2019, 10(27):6888－6895.
[16] Pedersen J H, Saghir Z, Wille M M W, et al. Ground-glass opacity lung nodules in the era of lung cancer CT screening: radiology, pathology, and clinical management[J]. Oncology, 2016, 30(3):266－274.
[17] Honda Y, Oka S, Chikaishi Y, et al. Mediastinal lymph node metastases in lung cancer presenting as pure ground-glass nodules: a surgical case report[J]. Int J Surg Case Rep, 2020, 70: 5－7.
[18] Tsutani Y, Miyata Y, Nakayama H, et al. Appropriate sublobar resection choice for ground glass opacity-dominant clinical stage IA lung adenocarcinoma: wedge resection or segmentectomy[J]. Chest, 2014, 145(1):66－71.

老年肺部磨玻璃影患者的影像学特征及术后病理分析

Postoperative pathological analysis of elderly pulmonary ground-glass opacity

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