34例肺单纯性磨玻璃样病灶的临床分析

Clinical analysis of 34 cases of pulmonary pure ground-glass opacity

目的探讨肺单纯性磨玻璃样病灶(pGGO)临床病理学特征、手术方式及预后。方法收集34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、肿瘤组织学类型及淋巴结转移和患者预后情况。结果本组女性和不吸烟患者明显多于男性和吸烟患者(P<0.05,P<0.01)。34例患者中,接受局部切除(楔形切除或肺段切除)19例(电视胸腔镜下手术18例),肺叶切除15例。术后病理学检查显示:非典型腺瘤样增生13例,肺泡细胞癌21例;均无淋巴结转移。肺泡细胞癌病灶直径明显大于非典型腺瘤样增生病灶(P<0.05);局部切除与肺叶切除病灶大小比较差异无统计学意义。术后随访3个月～5年,患者均存活,无肿瘤复发及远处转移。结论 pGGO多发于不吸烟女性。pGGO中多数肺泡细胞癌病灶直径大于非典型腺瘤样增生病灶。电视胸腔镜下局部切除对pGGO的治疗效果良好。

Objective To investigate the clinicopathological characteristics,surgical procedures and prognosis of pulmonary pure ground-glass opacity(pGGO). Methods The clinical data of 34 patients with pGGO were collected,and the gender constitution,smoking status,surgical procedures,lesion size,histological types of tumor,lymph node metastasis and prognosis were retrospectively analysed. Results The numbers of females and non-smokers were significantly larger than those of males and smokers(P<0.05,P<0.01).Nineteen of the 34 patients received local resection(wedge resection or segment resection,video-assisted thoracoscopic surgery in 18),and the other 15 patients underwent lobectomy.Pathological examinations after operation revealed that there were 21 cases of bronchioloalveolar carcinoma and 13 cases of atypical adenomatous hyperplasia,and there was no lymph node metastasis.The diameters of bronchioloalveolar carcinoma lesions were significantly longer than those of atypical adenomatous hyperplasia lesions(P<0.05),while there was no significant difference in lesion size between cases of local resection and those of lobectomy.Patients were followed up for 3 months to 5 years,and all survived,with no recurrence and distant metastasis. Conclusion The majority of patients with pGGO are females and nonsmokers.The diameters of bronchioloalveolar carcinoma lesions are longer than those of atypical adenomatous hyperplasia lesions.Local resection under video-assisted thoracoscopic surgery is recommended for treatment of pGGO.