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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 ...

已有 612 次阅读2021-3-18 17:44 |个人分类:TET学习|系统分类:医学科学| 磨玻璃阴影, 肺结节

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. 2019
Distinct Clinicopathologic Characteristics and Prognosis Based on the Presence of Ground Glass Opacity Component in Clinical Stage IA Lung Adenocarcinoma

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。


Introduction: We evaluated differences in the clinicopathologic characteristics and prognosis based on the presence of ground glass opacity (GGO) components in small-sized lung adenocarcinoma.

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.


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回复 hyc3140 2021-3-18 17:47
Hattori A, Hirayama S, Matsunaga T, Hayashi T, Takamochi K, Oh S, Suzuki K. Distinct Clinicopathologic Characteristics and Prognosis Based on the Presence of Ground Glass Opacity Component in Clinical Stage IA Lung Adenocarcinoma. J Thorac Oncol. 2019 Feb;14(2):265-275. doi: 10.1016/j.jtho.2018.09.026. Epub 2018 Oct 25. PMID: 30368010.

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