Journal article
Predicting malignancy: subsolid nodules detected on LDCT in a surgical cohort of East Asian patients
Journal of thoracic disease, Vol.12(8), pp.4315-4326
08/01/2020
DOI: 10.21037/jtd-20-659
PMID: 32944344
Abstract
Background: Due to widespread use of low-dose computed tomography (LDCT) screening, increasing number of patients are found to have subsolid nodules (SSNs). The management of SSNs is a clinical challenge and primarily depends on CT imaging. We seek to identify risk factors that may help clinicians determine an optimal course of management.
Methods: We retrospectively reviewed the characteristics of 83 SSN lesions, including 48 pure groundglass nodules and 35 part-solid nodules, collected from 83 patients who underwent surgical resection.
Results: Of the 83 SSNs, 16 (19.28%) were benign and 67 (80.72%) were malignant, including 23 adenocarcinomas in situ ( AIS), 16 minimally invasive adenocarcinomas (MIA), and 28 invasive adenocarcinomas (IA). Malignant lesions were found to have significantly larger diameters (P<0.05) with an optimal cut-off point of 9.24 mm. Significant indicators of malignancy include female sex (P<0.05), air bronchograms (P<0.001), spiculation (P<0.05), pleural tail sign (P<0.05), and lobulation (P< 0.05). When compared with AIS/MIA combined, IA lesions were found to be larger (P<0.05) with an optimal cutoff of 12 mm, and have a higher percentage of part-solid nodules (P<0.001), pleural tail sign (P<0.001), air bronchograms (P<0.05), and lobulation (P<0.05). Further multivariate analysis found that lesion size and spiculation were independent factors for malignancy while part-solid nodules were associated with IA histology.
Conclusions: East Asian females are at risk of presenting with a malignant lesion even without history of heavy smoking or old age. Nodule features associated with malignancy include larger size, air bronchograms, lobulation, pleural tail sign, spiculation, and solid components. A combination of patient characteristic and LDCT features can be effectively used to guide management of patients with SSNs.
Details
- Title: Subtitle
- Predicting malignancy: subsolid nodules detected on LDCT in a surgical cohort of East Asian patients
- Creators
- Yung-Hsien Wang - Taipei Medical UniversityChieh-Feng Chen - Taipei Med Univ, Coll Med, Grad Inst Clin Med, Taipei, TaiwanYen-Kuang Lin - Taipei Med Univ, Biostat Res Ctr, Taipei, TaiwanCaleb Chiang - Duke UniversityChing Tzao - Kuang Tien General HospitalYun Yen - Taipei Medical University
- Resource Type
- Journal article
- Publication Details
- Journal of thoracic disease, Vol.12(8), pp.4315-4326
- DOI
- 10.21037/jtd-20-659
- PMID
- 32944344
- NLM abbreviation
- J Thorac Dis
- ISSN
- 2072-1439
- eISSN
- 2077-6624
- Publisher
- AME PUBLISHING COMPANY
- Number of pages
- 12
- Grant note
- "TMU Research Center of Cancer Translational Medicine" from The Featured Areas Research Center Program within the Ministry of Education (MOE) in Taiwan; Taipei Medical University MOST 106-3114-B-038-001; MOST 107-2321-B-038-002; MOST 108-2321-B-038-003 / Ministry of Science and Technology; National Science & Technology Council (NSTC) Taiwan MOHW107-TDU-B-212-114020; MOHW107-TDU-B-212-114014; MOHW107-TDU-B-212-114026B / Health and welfare surcharge of tobacco products grant
- Language
- English
- Date published
- 08/01/2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985218376402771
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