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2026年8月29日星期六
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解码恶性肺磨玻璃影：从纯到半实性病变的放射-病理研究

Decoding Malignant Lung Ground Glass Opacities: A Radiologic-Pathologic Study From Pure to Semi-Solid Lesions.

期刊
Thoracic Cancer
PMID
42663505
原文
PubMed ↗
发布日期

作者

  • Alessandro Bonis — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Giulia Pagliarini — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Vincenzo Verzeletti — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Sara Cecchinato — Unit of Advanced Clinical and Translational Imaging, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Anna Michielin — Unit of Advanced Clinical and Translational Imaging, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Serena Zanardo — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Marco De Silvestro — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Luigi Lione — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Chiara Giraudo — Unit of Advanced Clinical and Translational Imaging, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Eleonora Faccioli — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Giorgio Cannone — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Marco Mammana — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Alessandro Rebusso — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Giovanni Maria Comacchio — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Marco Schiavon — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Andrea Dell'Amore — Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.

作者单位

  • Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.
  • Unit of Advanced Clinical and Translational Imaging, Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, Padova, Italy.

摘要

中文

由于肺癌低剂量CT筛查的普及，磨玻璃影（GGOs）的检出率日益增加。其中，恶性GGOs（mGGOs）是临床挑战。本研究旨在比较纯和半实性mGGOs的放射学与解剖病理学特征，并确定实性成分的放射学预测因素。对2016年至2023年间因mGGOs接受手术切除的患者进行回顾性研究。根据初始纯mGGOs在术前是否保持纯性或出现实性成分对患者进行分组。分析放射学、病理学和分子特征。135例患者中，61例（46%）mGGOs在随访期间变为部分实性。半实性mGGOs具有更高的腺泡成分（p=0.038）和更大的病理直径（20对18mm，p=0.047），而纯mGGOs具有更高的贴壁成分百分比（20%对10%，p=0.026）。STAS和LVI分别见于25%和15%的病例。Logistic回归显示胸膜接触对实性化具有保护作用（p=0.033），而动脉血管化可预测实性化（p=0.028）。两组的五年生存率相当且令人满意（纯性81.7%，半实性85.5%）。总体而言，LVI（而非STAS）是整个样本中生存预期降低的原因，与实性化无关（p=0.004）。纯性和半实性mGGOs均显示出早期病理和分子特征。根治性手术干预即使对于纯GGOs也伴随着较长的预期生存期。影像学上的血管特征可能有助于手术决策，而病理LVI可能对mGGOs患者具有预后意义。

English

Ground-glass opacities (GGOs) are increasingly detected due to widespread low-dose CT screening for lung cancer. Among them, malignant GGOs (mGGOs) are a clinical challenge. This study aimed to compare the radiological and anatomopathological characteristics of pure and semi-solid mGGOs and to identify radiological predictive factors for consolidation. A retrospective study was conducted on patients resected due to mGGOs between 2016 and 2023. Patients were classified based on whether initially pure mGGOs remained pure or developed a solid component before surgery. Radiological, pathological, and molecular characteristics were analyzed. Of 135 patients, 61 (46%) mGGOs became partially solid during surveillance. Semi-solid mGGOs had a higher acinar component (p = 0.038) and larger pathological diameter (20 vs. 18 mm, p = 0.047), while pure mGGOs had a higher lepidic percentage (20% vs. 10%, p = 0.026). STAS and LVI were observed in 25% and 15% of cases. Logistic regression showed pleural contact was protective against consolidation (p = 0.033), while arterial vascularization was predictive of consolidation (p = 0.028). Five-year survival was comparable and satisfactory for both groups (81.7% for pures and 85.5% for semi-solids). Overall, LVI but no STAS was cause of a lower survival expectancy in the entire sample, regardless of consolidation (p = 0.004). Both pure and semi-solid mGGOs showed precocious pathological and molecular features. Surgical intervention with curative intent, even in pure GGOs, is accompanied by long expected survivals. Vascular features on imaging may help inform surgical decision-making, whereas pathological LVI may have prognostic significance in patients with mGGOs.

分类与指标

研究类型
临床研究
病种
肺癌
JCR 分区
Q2
影响因子
2.6
新锐分区
4区