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J Cardiothorac Surg. 2018 Jan 17;13(1):9. doi: 10.1186/s13019-018-0696-7.

Identification of preoperative prediction factors of tumor subtypes for patients with solitary ground-glass opacity pulmonary nodules.

Li M1,2,3,4, Wang Y1,2,3,4, Chen Y1,2,3,4, Zhang Z5,6,7,8.

Author information

1
Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Huanhu West Road, Tianjin, 300060, China.
2
National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
3
Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.
4
Tianjin Lung Cancer Center, Tianjin, 300060, China.
5
Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, Huanhu West Road, Tianjin, 300060, China. zhangzhenfa1973@163.com.
6
National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China. zhangzhenfa1973@163.com.
7
Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China. zhangzhenfa1973@163.com.
8
Tianjin Lung Cancer Center, Tianjin, 300060, China. zhangzhenfa1973@163.com.

Abstract

BACKGROUND:

Recent wide spread use of low-dose helical computed tomography for the screening of lung cancer have led to an increase in the detection rate of very faint and smaller lesions known as ground-glass opacity nodules. The purpose of this study was to investigate the clinical factors of lung cancer patients with solitary ground-glass opacity pulmonary nodules on computed tomography.

METHODS:

A total of 423 resected solitary ground-glass opacity nodules were retrospectively evaluated. We analyzed the clinical, imaging and pathological data and investigated the clinical differences in patient with adenocarcinoma in situ / minimally invasive adenocarcinoma and those with invasive adenocarcinoma.

RESULTS:

Three hundred and ninety-three adenocarcinomas (92.9%) and 30 benign nodules were diagnosed. Age, the history of family cancer, serum carcinoembryonic antigen level, tumor size, ground-glass opacity types, and bubble-like sign in chest CT differed significantly between adenocarcinoma in situ / minimally invasive adenocarcinoma and invasive adenocarcinoma (p:0.008, 0.046, 0.000, 0.000, 0.000 and 0.001). Receiver operating characteristic curves and univariate analysis revealed that patients with more than 58.5 years, a serum carcinoembryonic antigen level > 1.970 μg/L, a tumor size> 13.50 mm, mixed ground-glass opacity nodules and a bubble-like sign were more likely to be diagnosed as invasive adenocarcinoma. The combination of five factors above had an area under the curve of 0.91, with a sensitivity of 82% and a specificity of 87%.

CONCLUSION:

The five-factor combination helps us to distinguish adenocarcinoma in situ / minimally invasive adenocarcinoma from invasive adenocarcinoma and to perform appropriate surgery for solitory ground-glass opacity nodules.

KEYWORDS:

Clinical features; Five-factor combination; Pathology; ROC curve; Solitory ground-glass opacity pulmonary nodules

PMID:
29343293
PMCID:
PMC5772707
DOI:
10.1186/s13019-018-0696-7
[Indexed for MEDLINE]
Free PMC Article

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