|
|
|
| Comparative analysis of ground glass nodular lung adenocarcinoma CT imaging features and pathologic classification |
| REN Kai-ming1, ZHAO Jun-gang1, LIN Ai-jun1, MA Quan-mei1, ZHOU Zhao-li2, LU Ji-bin1 |
| 1. Shengjing Hospital of China Medical University, Shenyang 110004, China;
2. Shanghai University of Medicine & Health Sciences, Shanghai 201318, China |
|
|
|
|
Abstract Objective: To study and compare the relationship between high-resolution computed tomography(HRCT) imaging signs of lung ground glass nodules(GGN) and the new pathological classification of early-stage lung adenocarcinoma in order to improve the diagnosis of GGN. Methods: The HRCT data of postperative 116 patients with pathologically confirmed pulmonary GGN were retrospectively analyzed. According to the newest pathological classification criteria for lung adenocarcinoma, they were divided into 3 groups: 41 in the infiltration group, including 16 cases of atypical adenomatous hyperplasia(AAH), 25 cases of carcinoma in situ(AIS); 33 cases of micro-invasive carcinoma(MIA) group; 42 cases of invasive adenocarcinoma(IAC) group. The GGN size, density, lobulation sign, burr sign, pleural stretch sign, vascular cluster sign, air bronchogram were evaluated for each group and statistical analysis was done. Results: The distribution of the lesion size had a significant difference among the three groups(P<0.01). The distribution of lobulation sign and burr sign had significant differences among the three groups(P<0.01). The comparison between the pleural stretch signs showed that there were significant differences between the infiltration group, the MIA group, and the IAC group(P<0.01), but there was no significant difference between the infiltration group and the MIA group(P>0.05). Compared between vascular cluster signs, MIA group and IAC group were higher than those before infiltration group, and the difference was statistically significant(P<0.01). There was no significant difference between MIA group and IAC group(P>0.05). The distribution of cavitation sign, air bronchogram and lesions density had no significant differences among the three groups. Conclusion: The lesion size, lobular sign, burr sign, pleural stretch sign, vascular cluster sign are important CT imaging features that distinguish pre-infiltrating lesion, MIA and IAC can improve the understanding of the new pathological classification of micro GGN-like lung adenocarcinoma.
|
|
Received: 08 April 2019
|
|
|
|
|
|
| [1]Callister MEJ, Baldwin DR, Akram AR, et al. British Thoracic Society guidelines for the investigation and management of pulmonary nodules[J]. Thorax, 2015, 70(Suppl 2): ii1-ii54.
[2]Chheang S, Brown K. Lung cancer staging: clinical and radiologic perspectives[J]. Semin Intervent Radiol, 2013, 30(2): 99-113.
[3]Travis WD, Brambilla E, Noguchi M, et al． International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society: international multidisciplinary classification of
lung adenocarcinoma: executive summary[J]. J Thorac Oncol, 2011, 6(2): 244-285．
[4]钟文昭，董嵩，李磊，等. 国际肺癌研究协会/美国胸科学会/欧洲呼吸学会肺腺癌的国际多学科分类[J]. 循证医学，2011，11（4）：193-225．
[5]Zhang J, Wu J, Tan Q, et al. Why do pathological stage IA lung adenocarcinomas vary from prognosis?: a clinicopathologic study of 176 patients with pathological stage IA lung adenocarcinoma based on the IASLC/ATS/ERS classification[J]. J Thorac Oncol, 2013, 8(9): 1196-1202.
[6]Patz EF, Pinsky P, Gatsonis C, et al. Overdiagnosis in low-dose computed tomography screening for lung cancer[J]. JAMA Intern Med, 2014, 174(2): 269-274.
[7]Macmahon H, Naidich DP, Goo JM, et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: from the Fleischner Society 2017[J]. Radiology, 2017, 284(1): 228-243.
[8]Lee SM, Park CM, Goo JM, et al. Invasive pulmonary adenocarcinomas versus preinvasive lesions appearing as ground-glass nodules: differentiation by using CT features[J]. Radiology, 2013, 268(1): 265-273.
[9]Eguchi T, Yoshizawa A, Kawakami S, et al． Tumor size and computed tomography attenuation of pulmonary pure ground-glass nodules are useful for predicting pathological invasiveness[J]. PLoS One, 2014, 9(5): e97867.
[10]Zhang Y, Qiang JW, Ye JD, et al. High resolution CT in differentiating minimally invasive component in early lung adenocarcinoma[J]. Lung Cancer, 2014, 84(3): 236-241.
[11]Xiang W, Xing Y, Jiang S, et al. Morphological factors differentiating between early lung adenocarcinomas appearing as pure ground-glass nodules measuring ≤10 mm on thin-section computed tomography[J]. Cancer Imaging, 2014, 14: 33.
[12]Lee KH, Goo JM, Park SJ, et al. Correlation between the size of the solid component on thin-section CT and the invasive component on pathology in small lung adenocarcinomas manifesting as ground-glass nodules[J]. J Thorac Oncol, 2014, 9(1): 74-82.
[13]Cohen JG, Reymond E, Lederlin M, et al. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients[J]. Eur J Radiol, 2015, 84(4): 738-744.
[14]Ichinose J, Kohno T, Fujimori S, et al． Invasiveness and malignant potential of pulmonary lesions presenting as pure ground-glass opacities[J]. Ann Thorac Cardiovasc Surg, 2014, 20(5): 347-352．
[15]张国桢，郑向鹏，李铭． 微小肺癌——影像诊断与应对策略[M]. 北京：人民军医出版社，2015：84-85． |
|
|
|
