Pathology and prognosis of persistent stable pure ground-glass opacity nodules after surgical resection

Background: This study aimed to show the pathologic results of pure ground glass opacities (pGGOs) that showed no change in patients who underwent surgical resection.

Methods: The data used in this study were collected from the records of patients who underwent surgical resection for pGGOs between January 2004 and December 2009. All pGGOs were detected and followed up until operation with high-resolution computed tomography at our hospital and were followed up by computed tomography of the chest at least 2 years after operation. Surgical resection was performed for patients with pGGOs if no change was observed after a minimum of 1 month of follow-up and if any growth of the nodules or newly formed solid components occurred in pGGOs of any size.

Results: Forty-six patients were enrolled into the study group. No changes in the pGGOs during serial follow-up occurred in 39 patients (84.8%), and 7 patients (15.2%) underwent surgical resection because of growth of the lesions or newly developed solid lesions during follow-up. Of 39 patients in the no-change group, pathologic types of the cancerous pGGOs in 23 patients included adenocarcinoma in situ in 21 patients, minimally invasive adenocarcinoma in 1 patient, and invasive adenocarcinoma in 1 patient. In the change group, 5 patients were diagnosed with cancer. Between the two groups, there was no difference in sex, time intervals, or tumor size. Neither group had lymph node metastasis or recurrence.

Conclusions: This study showed the pathology of persistent stable pGGO postoperatively, which confirmed the 59% chance of a cancer diagnosis including adenocarcinoma in situ, minimally invasive adenocarcinoma, or invasive adenocarcinoma.