Runze Li, Jianchuan Chen, Zhifei Li, Peng Li, Bin Qiu, Fengwei Tan
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引用次数: 0
摘要
背景：肺下实性结节是肺癌中的一个独特群体，其生物学行为侵袭性较低，生存率较高。我们旨在研究地玻璃不透明（GGO）对临床ⅠA期（cIA）高代谢肺腺癌预后的影响：方法：我们对来自单个机构数据库的高代谢和/或纯固性cIA肺腺癌切除患者进行了一项回顾性研究。主要结果是无复发生存期（RFS）。次要结果包括总生存期、病理结节分期和复发率：共审查了 621 例患者，并将其分为三组：低代谢实性结节（SNs）患者分为 A 组（128 例），高代谢磨玻璃结节（GGNs）患者分为 B 组（105 例），高代谢 SNs 患者分为 C 组（388 例）。在cT1a + T1b（93.3% vs. 72.5%，p = 0.002）亚组中，B组的五年RFS明显优于C组，但在cT1c（73.4% vs. 69.0%，p = 0.23）亚组中，B组的五年RFS不明显优于C组。多变量分析显示，在高代谢亚组中，GGO成分是RFS的独立预后因素（危险比[HR] = 0.41，95%置信区间[CI]：0.19-0.89，P = 0.02），也是结节向上分期的保护因素（几率比[OR] = 0.44，95%置信区间[CI]：0.21-0.94，P = 0.03）。除1例术后复发外，所有GGN的实体成分大小均大于2厘米：结论：即使在高代谢cIA肺腺癌中，GGO成分的存在也是一个独立的预后因素。然而，在不同的T分类中，高代谢GGN的肿瘤预后并不一样好。
Reassessment of the Prognostic Implication of Ground-Glass Opacity: An Investigation Into Hypermetabolic Clinical Stage IA Lung Adenocarcinoma.
Background: Subsolid lung nodules represent a distinct group of lung cancers with less-aggressive biological behavior and favorable survival. We aimed to examine the prognostic impact of the ground-glass opacity (GGO) in clinical stage IA (cIA) lung adenocarcinoma with high metabolic activity.
Methods: A retrospective study was conducted among patients with resected hypermetabolic and/or pure-solid cIA lung adenocarcinoma from a single institution database. The primary outcome was recurrence-free survival (RFS). The secondary outcomes included overall survival, pathological nodal upstaging, and recurrence rate.
Results: A total of 621 patients were reviewed and classified into three groups: patients with low metabolic, solid nodules (SNs) into group A (N = 128), patients with hypermetabolic ground-glass nodules (GGNs) into group B (N = 105), and patients with hypermetabolic SNs into group C (N = 388). The five-year RFS of group B was significantly better than that of group C in the cT1a + T1b (93.3% vs. 72.5%, p = 0.002) subgroup but not in the cT1c (73.4% vs. 69.0%, p = 0.23) subgroup. Multivariable analysis showed that GGO component was an independent prognostic factor of RFS (hazard ratio [HR] = 0.41, 95% confidence interval [CI]: 0.19-0.89, p = 0.02) and protective factor of nodal upstaging (odds ratio [OR] = 0.44, 95% CI: 0.21-0.94, p = 0.03) among the hypermetabolic subgroup. All except one postoperative recurrence occurred in GGNs with solid component size > 2 cm.
Conclusions: The presence of GGO component was an independent prognostic factor even in hypermetabolic cIA lung adenocarcinoma. However, the oncologic outcomes of hypermetabolic GGNs were not equally favorable in different T categories.
期刊介绍：
Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society.
The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.
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