Objective Despite the vital role of blood perfusion in tumor progression, in patients with persistent pulmonary nodule with ground-glass opacity (GGO) is still unclear. This study aims to investigate the relationship between tumor blood vessel and the growth of persistent malignant pulmonary nodules with ground-glass opacity (GGO). Methods We collected 116 cases with persistent malignant pulmonary nodules, including 62 patients as stable versus 54 patients in the growth group, from 2017 to 2021. Three statistical methods of logistic regression model, Kaplan–Meier analysis regression analysis were used to explore the potential risk factors for growth of malignant pulmonary nodules with GGO. Results Multivariate variables logistic regression analysis and Kaplan–Meier analysis identified that tumor blood vessel diameter ( p = 0.013) was an significant risk factor in the growth of nodules and Cut-off value of tumor blood vessel diameter was 0.9 mm with its specificity 82.3% and sensitivity 66.7%.While in subgroup analysis, for the GGO CTR < 0.5[C(the maximum diameter of consolidation in tumor)/T(the maximum diameter of the whole tumor including GGO) ratio], tumor blood vessel diameter ( p = 0.027) was important during the growing processes of nodules. Conclusions The tumor blood vessel diameter of GGO lesion was closely associated with the growth of malignant pulmonary nodules. The results of this study would provide evidence for effective follow-up strategies for pulmonary nodule screening.

Abstract Objective The objective of the study was to investigate the volume (VDT) and mass doubling time (MDT) of growing malignant ground-glass opacity(GGO) and explore the relationships between doubling times and clinical-pathological features. Methods We collected 37 GGO cases (18 male & 19 female with age between 43- and 82-year-old) between 2016 and 2020 and all of these cases were along with growing malignant pulmonary nodules. The duration of follow-up and the variation in GGOs volume and mass were recorded. The morphologic changes and three-dimensional segmentation of GGO nodules were used to calculate the VDT and MDT based on a modified Schwartz model. The independent sample t-test was used to investigate the relationship between doubling times and their features. Logistic regression was used to evaluate the risk factors of growing malignant GGOs. Results The median follow-up time was 725 days (31-1507 days). The averaged VDT and MDT of the GGOs were 973 days and 671 days, respectively. Both VDT and MDT were significantly different among the three different groups of solid components of GGO(p<0.05). The vacuole sign and lepidic-predominant lung adenocarcinoma (LPA) also made an important role in changing the VDTs and MDTs (p<0.05). In addition, the growth of malignant pulmonary nodules was significantly associated with air bronchus sign (OR 6.667; 95% CI of 1.126-39.470; p=0.037). Multivariate analysis showed that LPA declined the GGOs growth (odds ratio 0.093, 95% CI of 0.011-0.765, p = 0.027). Conclusions The solid component of GGOs and vacuole sign were closely associated with the growth rate of GGOs. The GGOs with air bronchus sign was more dangerous in terms of growth rate than other GGO cases. However, the appearance of LPA could inhibit GGO growth. Further studies are still required to verify the obtained results.

ObjectiveThe aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections.MethodsA meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections.ResultsResults showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): - 1.04 days; 95% CI - 1.50 to - 0.58; P < 0.01) WMD - 0.71 days; 95% confidence interval (CI), - 1.08 to - 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21-0.92; P = 0.03, I-2 = 0%].ConclusionsAlthough the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.

BACKGROUND:The object of the study was to elucidate the relationship between the neutrophil-lymphocyte ratio (NLR) and the growth of pulmonary ground-glass opacity (GGO) in stage IA lung adenocarcinoma.METHODS:All patients with GGO following surgical procedures were enrolled, with the time of follow-up and the variation tendency of GGO recorded. Meanwhile, laboratory parameters, age, gender, smoking history, histology, tumor size, and stage were recorded. Logistic regression was used to evaluate the value of NLR and the cutoff value was calculated by SPSS 22.0.RESULTS:In the whole cohort, 30 cases of growing GGO and 43 cases of stable GGO undergoing surgical procedures were diagnosed as lung adenocarcinoma. There was significant statistical difference between the two groups. Multivariable analysis showed that NLR could predict the GGOs with growth (odds ratio 5.198, 95% confidence interval (95%CI: 1.583-14.581, P=0.002). Receiver operating characteristics analysis for NLR showed the optimal cutoff value of 2.38, with a sensitivity of 60.0% and specificity of 81.4%.CONCLUSION:Our study demonstrated that the NLR appeared to have value as a promising clinical predictor of GGOs with growth. Further studies are needed to confirm this conclusion.