磨玻璃密度成分对临床IA期非小细胞肺癌预后的影响_J Thorac Cardiovasc Surg. 2021 .. ...

目的：我们根据日本临床肿瘤学组研究JCOG0201的数据进行了一项验证性研究，以证实磨玻璃样密度成分的存在对预后的重要性，JCOG0201是一项预测日本临床IA期肺癌病理无创性的前瞻性观察性研究。

方法：在JCOG0201中登记的811例患者中，671例经研究监测和CT扫描中心复查证实符合条件。已登记的c期IA肺癌最大肿瘤径线小于30mm，根据磨玻璃样密度成分的状态分为磨玻璃样阴影组（纯磨玻璃样和部分实性肿瘤）和实性组。根据第8版TNM分期系统重新分配T分期。为了验证预后的影响，估计了总生存率。

结果：磨玻璃样密度组432例（64%），实性组239例（36%），中位随访时间10.1年。磨玻璃样密度组和实性组的5年总生存率有显著性差异（95.1%对81.1%）。磨玻璃样密度组的5年总生存率良好，无论实体成分大小（c-T1a或更小：97.2%，c-T1b:93.4%，c-T1c:91.7%）。相反，实体瘤组肿瘤大小对预后的影响是明确的（c-T1a:87.5%，c-T1b:85.9%，c-T1c:73.7%）。

结论：JCOG0201显示磨玻璃样密度成分对预后有良好影响。磨玻璃样密度的存在与否应作为下一个临床T分类的重要参数。

关键词：临床T分型；磨玻璃样密度；预后；单纯实体瘤。

Objective: We performed a validation study to confirm the prognostic importance of the presence of a ground-glass opacity component based on data of the Japan Clinical Oncology Group study, JCOG0201, which was a prospective observational study to predict the pathological noninvasiveness of clinical stage IA lung cancer in Japan.

Methods: Among the 811 patients registered in JCOG0201, 671 were confirmed eligible by study monitoring and a central review of computed tomography. Registered c-stage IA lung cancer was less than 30 mm in maximum tumor size, which was classified into a with ground-glass opacity group (pure ground-glass opacity and part-solid tumor) or solid group based on the status of a ground-glass opacity component. T staging was reassigned in accordance with the 8th edition of the TNM staging system. To validate the prognostic impact, overall survival was estimated.

Results: Of the cases, 432 (64%) were in the with ground-glass opacity group and 239 (36%) were in the solid group with a median follow-up time of 10.1 years. The 5-year overall survival was significantly different between the with ground-glass opacity group and solid group (95.1% vs 81.1%). The 5-year overall survival was excellent regardless of the solid component size in the with ground-glass opacity group (c-T1a or less: 97.2%, c-T1b: 93.4%, c-T1c: 91.7%). In contrast, prognostic impact of the tumor size was definitive in the solid group (c-T1a: 87.5%, c-T1b: 85.9%, c-T1c: 73.7%).

Conclusions: Favorable prognostic impact of the presence of a ground-glass opacity component was demonstrated in JCOG0201. The presence or absence of a ground-glass opacity should be considered as an important parameter in the next clinical T classification.

Keywords: clinical-T classification; ground-glass opacity; prognosis; pure-solid tumor.