Identification of preoperative prediction factors of tumor subtypes for patients with solitary ground-glass opacity pulm
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RESEARCH ARTICLE
Open Access
Identification of preoperative prediction factors of tumor subtypes for patients with solitary ground-glass opacity pulmonary nodules Meishuang Li1,2,3,4, Yanan Wang1,2,3,4, Yulong Chen1,2,3,4 and Zhenfa Zhang1,2,3,4*
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: Solitory ground-glass opacity pulmonary nodules, ROC curve, Clinical features, Five-factor combination, Pathology
Background Recent widespread use of low-dose helical computed tomography (CT) 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 (GGO) nodules. GGO is a nonspecific finding that may be * Correspondence: [email protected] 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 Full list of author information is available at the end of the article
caused by various disorders, including inflammatory disease, hyperemia, focal fibrosis and neoplastic disease. The new interdisciplinary IASLC/ATS/ERS classification of lung adenocarcinoma has achieved a considerable impact since its publication in the yea
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