术前Hook-wire导丝定位的肺部磨玻璃结节临床病理特征分析

王斌; 张浩楠; 高炜; 张炜浩; 徐彦; 邢文阁; 司同国

doi:10.13418/j.issn.1001-165x.2019.02.003

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (2) : 130-134. DOI: 10.13418/j.issn.1001-165x.2019.02.003

断层影像解剖

术前Hook-wire导丝定位的肺部磨玻璃结节临床病理特征分析

王斌^{1, 2}，　张浩楠²，　高炜²，　张炜浩²，　徐彦²，　邢文阁²，　司同国²

作者信息 +

The postoperative clinicopathological characteristic of ground glass opacity localized by Hook-wire

WANG Bin^1,2, ZHANG Hao-nan², GAO Wei ², ZHANG Wei-hao ², XU Yan², XING Wen-ge², SI Tong-guo²

Author information +

文章历史 +

摘要

目的　评价术前Hook-wire导丝定位的肺部磨玻璃结节（ground glass opacity，GGO）临床、影像特征与病理的关系。方法　收集83例GGO患者的临床、影像与术后病理资料，分析单纯磨玻璃病变（pure ground glass opacity，pGGO）与混合磨玻璃病变（mixed ground glass opacity，mGGO）的临床、影像特征与病理之间的联系。结果　83个病灶（pGGO 36例，mGGO 47例）均导丝定位成功，无严重并发症发生。对比分析发现mGGO中浸润性腺癌（IAC）患者比例明显高于pGGO（21.7% vs 7.2%，P=0.004）；而且mGGO组直径大于1 cm者IAC患者比例明显高于直径小于1 cm者（29.8% vs 8.4%，P=0.003）；年龄、性别、位置分布与病理类型无明显差别。结论　mGGO中IAC患者比例明显高于pGGO；结节直径≥1.0 cm的mGGO患者需采取积极的治疗方案。

Abstract

　Objective　To evaluate the relationship between the clinical and imaging features of the postoperative clinicpathological characteristic of ground glass opacity (GGO) localized by Hook-wire. Methods　Retrospective analysis was made in 83 cases of GGO patients with a diameter less than 2 cm in clinical data, imaging data and postoperative pathology, analysis of imaging findings of pure ground glass opacity (pGGO) and mixed ground glass opacity (mGGO). The relationship between clinical, imaging features and postoperative pathology of GGO was analyzed.　Results　A total of 83 lesions (36 cases of pGGO and 47 cases of mGGO) were successfully localized by Hook-wire with no severe complications. Comparative analysis found that the proportion of patients with invasive adenocarcinoma (IAC) in mGGO was significantly higher than that of pGGO (21.7% vs 7.2%, P=0.004). The proportion of IAC patients with diameter greater than 1 cm in mGGO group was significantly higher than that with diameter less than 1 cm (29.8% vs 8.4%, P=0.003). There was no significant difference in age, gender, location distribution and pathological type.　Conclusion　The proportion of IAC patients in mGGO is significantly higher than that of pGGO. mGGO patients with opacity diameter ≥1.0 cm need to adopt active therapeutic plan.

导出引用

王斌,张浩楠,高炜,张炜浩,徐彦,邢文阁,司同国. 术前Hook-wire导丝定位的肺部磨玻璃结节临床病理特征分析[J]. 中国临床解剖学杂志. 2019, 37(2): 130-134 https://doi.org/10.13418/j.issn.1001-165x.2019.02.003

WANG Bin, ZHANG Hao-nan, GAO Wei, ZHANG Wei-hao, XU Yan, XING Wen-ge, SI Tong-guo. The postoperative clinicopathological characteristic of ground glass opacity localized by Hook-wire[J]. Chinese Journal of Clinical Anatomy. 2019, 37(2): 130-134 https://doi.org/10.13418/j.issn.1001-165x.2019.02.003

参考文献

[1] Gao JW, Rizzo S, Ma LH, et al. Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology[J]. Transl Lung Cancer Res, 2017, 6(1): 68-75.
[2] Park CM, Goo JM, Lee HJ, et al. Nodular ground-glass opacity at thin-section CT: histologic correlation and evaluation of change at follow-up[J]. Radiographics, 2007, 27(2): 391-408.
[3] Weichert W, Warth A. Early lung cancer with lepidic pattern: adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant adenocarcinoma[J]. Curr Opin Pulm Med, 2014, 20(4): 309-316.
[4] Lee HJ, Lee CH, Jeong YJ, et al. IASLC/ATS/ERS international multidisciplinary classification of lung adenocarcinoma: novel concepts and radiologic implications[J]. J Thorac Imaging, 2012, 27(6): 340-353.
[5] 游小风, 徐伟华. 肺内孤立性磨玻璃密度结节良恶性病灶的MSCT鉴别征象及其病理学基础[J]. 中国CT和MRI杂志, 2017, 15(12): 57-59.
[6] 王海燕, 柳澄, 孙丛, 等. 肺内磨玻璃结节CT特征与病理结果相关性分析[J]. 医学影像学杂志, 2018, 28(6): 936-940.
[7] 王吉平, 徐广全. 肺磨玻璃结节的影像学、病理学特点及临床管理[J]. 现代肿瘤医学, 2018, 26(5): 793-796.
[8] 袁如威, 王建良. 肺部局灶性磨玻璃结节的CT影像特征研究[J]. 医学影像学杂志, 2017, 27(10): 2019-2022.
[9] 窦郁, 卢星如, 马娴, 等. 孤立性肺实性结节和混杂磨玻璃结节对比研究[J]. 中国临床解剖学杂志, 2018, 36(6): 657-661.
[10]Wolf AS, Richards WG, Jaklitsch MT, et al. Lobectomy versus sublobar resection for small (2 cm or less) non-small cell lung cancers[J]. Ann Thorac Surg, 2011, 92(5): 1819-1823; discussion 1824-1815.
[11]Hsu CP, Hanke I, Douglas JM Jr. Diagnostic video-assisted thoracoscopic procedures[J]. Ann Surg, 1995, 222(5): 626-631.
[12]董志辉, 陆方方, 高鹏, 等. MSCT在肺磨玻璃结节诊断中的应用[J]. 中国CT和MRI杂志, 2018, 16(4): 63-65.
[13]Kim HY, Shim YM, Lee KS, et al. Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons[J]. Radiology, 2007, 245(1): 267-275.
[14]Kim D, Kim HK, Kim SH, et al. Prognostic significance of histologic classification and tumor disappearance rate by computed tomography in lung cancer[J]. J Thorac Dis, 2018, 10(1): 388-397.
[15]Aoki T, Tomoda Y, Watanabe H, et al. Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival[J]. Radiology, 2001, 220(3): 803-809.
[16]吴芳, 蔡祖龙, 田树平, 等. 1 cm以下磨玻璃密度肺腺癌的CT征象与病理亚型及免疫组织化学的相关性[J]. 中国医学科学院学报, 2015, 37(2): 163-170.
[17]Detterbeck FC, Homer RJ. Approach to the ground-glass nodule[J]. Clin Chest Med, 2011, 32(4): 799-810.
[18]Wood DE. National comprehensive cancer network (NCCN) clinical practice guidelines for lung cancer screening[J]. Thorac Surg Clin, 2015, 25(2): 185-197.
[19]Lee HY, Choi YL, Lee KS, et al. Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management[J]. AJR Am J Roentgenol, 2014, 202(3): W224-233.
[20]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[J]. J Thorac Oncol, 2011, 6(2): 244-285.