Surgical resection of nodular ground-glass opacities without percutaneous needle aspiration or biopsy

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• 作者：Jaeyoung Cho (10) (9)
  Sung-Jun Ko (10) (9)
  Se Joong Kim (10) (9)
  Yeon Joo Lee (10) (9)
  Jong Sun Park (10) (9)
  Young-Jae Cho (10) (9)
  Ho Il Yoon (10) (9)
  Sukki Cho (11) (12)
  Kwhanmien Kim (11) (12)
  Sanghoon Jheon (11) (12)
  Jae Ho Lee (10) (9)
  Choon-Taek Lee (10) (9)
  
  10. Division of Pulmonology and Critical Care Medicine ; Department of Internal Medicine ; Seoul National University Bundang Hospital ; Seongnam ; Korea
  9. Department of Internal Medicine ; Seoul National University College of Medicine ; Seoul ; Korea
  11. Department of Thoracic and Cardiovascular Surgery ; Seoul National University College of Medicine ; Seoul ; Korea
  12. Department of Thoracic and Cardiovascular Surgery ; Seoul National University Bundang Hospital ; Seongnam ; Korea
  
• 关键词：Nodular ground ; glass opacity ; Lung cancer ; Computed tomography ; Surgery ; Percutaneous needle aspiration or biopsy
• 刊名：BMC Cancer
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：462 KB
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  32. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/838/prepub
  
• 刊物主题：Cancer Research; Oncology; Stem Cells; Animal Models; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2407

文摘

Background Percutaneous needle aspiration or biopsy (PCNA or PCNB) is an established diagnostic technique that has a high diagnostic yield. However, its role in the diagnosis of nodular ground-glass opacities (nGGOs) is controversial, and the necessity of preoperative histologic confirmation by PCNA or PCNB in nGGOs has not been well addressed. Methods We here evaluated the rates of malignancy and surgery-related complications, and the cost benefits of resecting nGGOs without prior tissue diagnosis when those nGGOs were highly suspected for malignancy based on their size, radiologic characteristics, and clinical courses. Patients who underwent surgical resection of nGGOs without preoperative tissue diagnosis from January 2009 to October 2013 were retrospectively analyzed. Results Among 356 nGGOs of 324 patients, 330 (92.7%) nGGOs were resected without prior histologic confirmation. The rate of malignancy was 95.2% (314/330). In the multivariate analysis, larger size was found to be an independent predictor of malignancy (odds ratio, 1.086; 95% confidence interval, 1.001-1.178, p =0.047). A total of 324 (98.2%) nGGOs were resected by video-assisted thoracoscopic surgery (VATS), and the rate of surgery-related complications was 6.7% (22/330). All 16 nGGOs diagnosed as benign nodules were resected by VATS, and only one patient experienced postoperative complications (prolonged air leak). Direct surgical resection without tissue diagnosis significantly reduced the total costs, hospital stay, and waiting time to surgery. Conclusions With careful selection of nGGOs that are highly suspicious for malignancy, surgical resection of nGGOs without tissue diagnosis is recommended as it reduces costs and hospital stay.