肺单纯性磨玻璃影的临床病理特征分析

Clinical analysis of video-assisted thoracoscopic surgery for pulmonary pure ground-glass opacity

目的探讨肺单纯性磨玻璃影（pGGO）的临床特征、手术方式以及病理类型。方法收集39例pGGO患者的临床资料,回顾性分析患者的性别构成、吸烟状况、手术方式、病灶大小、肿瘤组织学类型、淋巴结转移和预后情况。结果全组女性和不吸烟患者明显多于男性和吸烟患者。39例患者中,接受局部切除（大楔形切除或肺段切除）31例,肺叶切除8例。术后病理学检查显示,非典型性腺瘤样增生11例（28.2%）,原位腺癌17例（43.6%）,微浸润腺癌4例（10.3%）,浸润性腺癌2例（5.1%）,良性结节5例（12.8%）。38例术中行淋巴结清扫或采样,患者均无淋巴结转移。病灶进展组与病灶无进展组、病灶最大径〉1 cm组与病灶≤1 cm组,浸润性病变比例分别为50%、9.1%（P=0.036）和25%、8.7%（P=0.205）。术后随访2~45个月,所有患者均生存,无肿瘤复发及远处转移。结论 pGGO多发于不吸烟女性。pGGO病灶最大径〉1 cm且病灶随访不缩小、或随访过程中病灶出现进展时应尽早手术治疗。电视胸腔镜局部切除pGGO的短期治疗效果良好。

Objective To investigate the clinical features,surgical procedures and histological types of video—assisted thoracascopic surgery for pulmonary pure ground—glass opacity.Methods The clinical data of 39 patients with pGGO by video—assisted thoracoscopic surgery were collected from January 2010 to May 2013.To analyze the relationship between gender constitution,smoking status,surgical procedures,lesion size,histological types of tumor,lymph node metastasis and prognosis.Results In the 39 patients,the numbers of females and non—smokers were larger than those of males and smokers.31 patients were treated with limited resection,8 patients were treated with lobectomy.Pathological examinations after operation showed that there were 11 cases（ 28.2%） of atypical adenomatous hyperplasia,17 cases（ 43.6%） of adenocarcinoma in stiu,4 cases（ 10.3%） of minimally invasive adenocarcinoma,2 cases（ 5.1%） of invasive adenocarcinoma,5 cases（ 12.8%） of benign nodules.And there was no lymph node metastasis.Compare disease progression and progression-free,the maximum diameter lesion〉1 cm and lesions ≤1 cm,the proportion of patients diagnosed with invasive lesions were 50.0% vs 9.1%（ P = 0.036）and 25.0 % vs 8.7%（ P = 0.205）.Patients were followed up for 2 months to 45 months,au patients survive without recurrence or distant metastasis.Conclusion Video-assisted thoracoscopic surgery for pure ground—glass opacity could achieve good short-term treatment.