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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.