Postoperative pathological analysis of elderly pulmonary ground-glass opacity

doi:10.3969/j.issn.1006-7795.2022.04.007

Abstract

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

CLC Number:

R655.3

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.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.04.007

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I4/552

References

[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.