基于IA期肺腺癌中存在磨玻璃样阴影成分的独特临床病理特征和预后_J Thorac Oncol. 201 ...

概述：我们根据小型肺腺癌中存在的磨玻璃阴影（GGO）成分评估了临床病理特征和预后的差异。

方法：我们回顾性研究了第八版TNM分类中的634例归为c期IA的肺腺癌。根据通过薄层计算机体层摄影术测量的实性成分大小定义分期。根据GGO成分的存在，将所有肿瘤分为GGO组或实体组。

结果：在这些病例中，有215名（34％）被分类为c期IA1（T1mi：88，T1a-GGO：102，T1a-solid：25），255（40％）被分类为c期IA2（T1b-GGO） ：122，T1b-固体：133）和164（26％）作为c-阶段IA3（T1c-GGO：44，T1c-固体：120）。在除T1mi病变以外的546例IA期IA病例中，Cox回归分析显示，GGO的存在是独立的重要预后因素（p = 0.024）。该结果在具有非主要GGO成分的494个c期IA IA肺腺癌中得到了验证，表明存在GGO作为重要的预后因子（p = 0.048）。当我们评估每个临床阶段中GGO存在的预后影响时，GGO和实体组之间的5年总生存率（OS）显着不同（IA1：97.8％对86.6％，p = 0.026； IA2：89.3％对75.2％，p = 0.007； IA3：88.5％对62.3％，p = 0.003）。此外，比较鳞状上皮性病变与浸润性成分时，其5年总体生存率b在平行的相似病理学发现中是不同的（IA1：97.9％对85.6％，p = 0.031； IA2：86.1％对69.4％，p = 0.007； IA3 ：77.5％对55.8％，p <0.001）。

结论：基于第八版T期IA肺腺癌TNM分类中存在GGO成分，临床病理和肿瘤学结果有所不同。

关键词：肺腺癌；诊断;毛玻璃不透明；生存分析。

Methods: We retrospectively investigated 634 lung adenocarcinomas classed as c-stage IA in the eighth edition TNM classification. Staging was defined according to the solid component size measured by thin-section computed tomography. All tumors were grouped into either a GGO or solid group, based on the presence of a GGO component.

Results: Of the cases, 215 (34%) were classed as c-stage IA1 (T1mi: 88, T1a-GGO: 102, T1a-solid: 25), 255 (40%) as c-stage IA2 (T1b-GGO: 122, T1b-solid: 133), and 164 (26%) as c-stage IA3 (T1c-GGO: 44, T1c-solid: 120). Among the 546 c-stage IA cases excluding the T1mi lesions, Cox regression analysis revealed that presence of GGO was an independently significant prognosticator (p = 0.024). The result was validated in 494 c-stage IA lung adenocarcinomas with a nonpredominant GGO component, showing the presence of GGO as a significant prognosticator (p = 0.048). When we evaluated the prognostic impact of GGO presence in each clinical stage, the 5-year overall survival (OS) was significantly different between the GGO and solid groups (IA1: 97.8% versus 86.6%, p = 0.026; IA2: 89.3% versus 75.2%, p = 0.007; IA3: 88.5% versus 62.3%, p = 0.003). Furthermore, the 5-year overall survival b was distinct in parallel similar pathologic findings when comparing a lepidic versus an invasive component (IA1: 97.9% versus 85.6%, p = 0.031; IA2: 86.1% versus 69.4%, p = 0.007; IA3: 77.5% versus 55.8%, p < 0.001).

Conclusions: Clinicopathologic and oncologic outcomes were disparate based on the presence of a GGO component in the eighth edition TNM classification of c-stage IA lung adenocarcinoma.

Keywords: Lung adenocarcinoma; diagnosis; ground glass opacity; survival analysis.

图1 根据临床T分类第8版的典型影像。肿瘤根据GGO组分为磨玻璃阴影（GGO）和实性组。

Figure 1Typical radiological images based on the eighth edition of the clinical T classification. Tumors were divided into ground glass opacity (GGO) and solid groups according to the presence of GGO components.