Clinical features and pathological types of pulmonary nodules with different components / 中国医师杂志

ABSTRACT

Objective:To investigate the clinical features, pathology and prognosis of pulmonary nodules.Methods:The data of patients with pulmonary nodules diagnosed by computed tomography (CT) in the Affiliated Hospital of Yangzhou University from 2015 to 2017 were analyzed retrospectively. The pathological results of all the nodules that were resected by video-assisted thoracoscopic surgery (VATS) were obtained definitely. Moreover, the prognosis of pulmonary nodules was also investigated by analyzing their clinical features and pathology.Results:Of all 117 pulmonary nodules, the number of pure ground glass nodules (pGGN), mixed ground glass nodules (mGGN) and solid nodules was 37, 64, and 16, respectively. Nodules of different compositions are more common in women, and are mostly located in the upper lobe of the right lung. There were significant differences in the pathological types of nodules with different components. The pathological results of pGGNs were mainly adenocarcinoma in situ (AIS) (51.4%, P<0.001), and mGGNs were also characterized by AIS (37.5%, P=0.001), while solid nodules were mainly invasive adenocarcinoma (IAC) and others ( P<0.001). Meanwhile, the diameter of solid nodules was significantly larger than that of mixed ground glass nodules and pure ground glass nodules [(17±8)mm, P<0.001], and the diameter of IAC in the mGGNs [(15±7)mm, P<0.001] and solid nodules [(22±8)mm, P=0.031] was significantly larger than other pathological types. In addition, the prevalence of complications after thoracoscopic surgery was 9.0% (10/111), and symptomatic treatment was effective after 1-3 months. Conclusions:The components and diameter of pulmonary nodules were closely related to lung adenocarcinoma. With the increase of solid components and diameter of nodules, it is possible to develop into IAC. Therefore, CT screening of pulmonary nodules is beneficial to the diagnosis and treatment for early lung cancer, and significant to the improvement of prognosis.