Prognostic implications of CT-defined ground glass opacity in clinical stage I-IIA grade 3 invasive non-mucinous pulmonary adenocarcinoma

L. Ding, J. Zhao, Y. Yang,M. S. Bhuva, P. Dipendra,X. Sun

CLINICAL RADIOLOGY(2024)

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摘要
AIM: To investigate the prognostic impact of computed tomography (CT) -defined ground glass opacity (GGO) in patients with clinical stage I-IIA grade 3 invasive non-mucinous pulmonary adenocarcinoma (INPA). MATERIALS AND METHODS: The present study retrospectively enrolled 187 patients diagnosed with stage I-IIA grade 3 INPA. Their clinicopathological, radiological, and genetic information was evaluated systematically, and a 5 -year follow-up was conducted to monitor disease recurrence and mortality. Patients were stratified based on the presence of a GGO component, and the Cox proportional hazard model was employed to assess the influence of clinicopathological factors and genetic variables on tumour outcomes. Recurrence -free survival (RFS) and overall survival (OS) were estimated using the Kaplan -Meier method and compared using the log -rank test. RESULTS: Significant differences were observed in both OS and RFS based on the presence of a GGO component. The group with GGO exhibited superior OS (p=0.0 02) and RFS (p=0.029). Multivariate analysis revealed that the presence of a GGO component (hazard ratio [HR] = 0.412, 95% confidence interval [CI]: 0.177-0.959, p=0.040), clinical T2 stage (HR=2.473, 95% CI: 1.498-4.083, p<0.001), pathological N2 stage (HR=3.049, 95% CI: 1.800-5.167, p<0.001), and mixed high-grade patterns (HR=2.392, 95% CI: 1.418-4.036, p=0.001) were predictors of RFS. CONCLUSION: The presence of a GGO component is strongly associated with a favourable prognosis in grade 3 INPA. (c) 2023 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
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