Accuracy and technical feasibility of mutual corroboration in the diagnosis of pulmonary nodule: A report of 1 368 cases_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GENG Guojun ^1,2 , MI Yanjun ¹ , ZHU Xiaolei ¹ , ZHAO Guang ¹ , LI Ning ¹ , LIU Hongming ¹ , GUO Weixi ¹ , SHI Sien ¹ , WANG Liangliang ¹ , YIN Pan ¹ , MA Jie ¹ ,  YU Xiuyi ¹ ,  JIANG Jie ¹

1. Department of Thoracic Surgery, The First Affiliated Hospital to Xiamen University, Xiamen, 361003, Fujian, P.R.China;
2. Teaching Hospital of Fujian Medical University, Xiamen, 361003, Fujian, P.R.China;

Corresponding author：

YU Xiuyi, Email: yuxiuyi@126.com; JIANG Jie, Email: jiangjie06@126.com

Keywords：

Pulmonary nodule; mutual corroboration in the diagnosis; pathological type; image characteristic

DOI：

10.7507/1007-4848.202002056

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Abstract Full text Figures/Tables Video References Cited by

Objective By applying the mutual corroboration in the diagnosis, we aimed to improve the accuracy of preoperative imaging diagnosis, select the appropriate timing of operation and guide the follow-up time for patients with pulmonary nodules.Methods Clinical data of 1 368 patients with pulmonary nodules undergoing surgical treatment in our department from July 2016 to October 2019 were summarized. There were 531 males and 837 females at age of 44 (21-67) years. The intraoperative findings, images and pathology were classified and analyzed. The imaging pathology and pathological changes of pulmonary nodules were shown as a dynamic process through mutual collaboration and interaction.Results Of 1 368 patients with pulmonary nodules, 376 (27.5%) were pure ground-glass nodules, 729 (53.3%) were mixed ground-glass nodules and 263 (19.2%) were solid nodules. Among the pure ground-glass nodules, adenocarcinoma in situ (AIS) accounted for the highest proportion (156 patients), followed by microinvasive adenocarcinoma (MIA, 90 patients), atypical adenomatous hyperplasia (AAH, 85 patients), and benign tumors (20 patients). Among mixed ground-glass nodules, 495 patients were invasive adenocarcinoma (IA) and 207 patients of MIA. In solid nodules, patients were characterized by pathology of either IA (213 patients) or benign tumors (50 patients), and no patient was featured by AAH, AIS or MIA.Conclusion The mutual collaboration and interaction can improve the accuracy of preoperative diagnosis of pulmonary nodules, and it supports the choice of operation timing and the judgment of follow-up time.

Citation： GENG Guojun, MI Yanjun, ZHU Xiaolei, ZHAO Guang, LI Ning, LIU Hongming, GUO Weixi, SHI Sien, WANG Liangliang, YIN Pan, MA Jie, YU Xiuyi, JIANG Jie. Accuracy and technical feasibility of mutual corroboration in the diagnosis of pulmonary nodule: A report of 1 368 cases. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(6): 669-674. doi: 10.7507/1007-4848.202002056 Copy

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13.	Liu G, Li M, Li G, et al. Assessing the blood supply status of the focal ground-glass opacity in lungs using spectral computed tomography. Korean J Radiol, 2018, 19(1): 130-138.
14.	Jin X, Zhao SH, Gao J, et al. CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity. Eur Radiol, 2015, 25(9): 2532-2540.
15.	Kim H, Goo JM, Kim YT, et al. CT-defined visceral pleural invasion in T1 lung adenocarcinoma: lack of relationship to disease-free survival. Radiology, 2019, 292(3): 741-749.

1. Snoeckx A, Reyntiens P, Desbuquoit D, et al. Evaluation of the solitary pulmonary nodule: size matters, but do not ignore the power of morphology. Insights Imaging, 2018, 9(1): 73-86.
2. Vlahos I, Stefanidis K, Sheard S, et al. Lung cancer screening: nodule identification and characterization. Transl Lung Cancer Res, 2018, 7(3): 288-303.
3. Sánchez M, Benegas M, Vollmer I. Management of incidental lung nodules J Thorac Dis. J Thorac Dis, 2018, 10(Suppl 22): S2611-S2627.
4. 聂永康, 蔡祖龙, 赵绍宏. 低剂量螺旋CT筛选检查早期肺癌的初步研究. 中华放射学杂志, 2002, 36(3): 230-234.
5. Rubin GD. Lung nodule and cancer detection in computed tomography screening. J Thorac Imaging, 2015, 30(2): 130-138.
6. Iaccarino JM, Simmons J, Gould MK, et al. Clinical equipoise and shared decision-making in pulmonary nodule management. A survey of American Thoracic Society Clinicians. Ann Am Thorac Soc, 2017, 14(6): 968-975.
7. Yang J, Wang H, Geng C, et al. Advances in intelligent diagnosis methods for pulmonary ground-glass opacity nodules. Biomed Eng Online, 2018, 17(1): 805-809.
8. Dhara AK, Mukhopadhyay S, Dutta A, et al. Content-based image retrieval system for pulmonary nodules: assisting radiologists in self-learning and diagnosis of lung cancer. J Digit Imaging, 2017, 30(1): 63-77.
9. Walter JE, Heuvelmans MA, Oudkerk M. Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening. Transl Lung Cancer Res, 2017, 6(1): 42-51.
10. 肖飞, 梁朝阳. 孤立性肺结节的良恶性判断及外科诊治进展. 中华胸心血管外科杂志, 2013, 29(7): 434-436.
11. 张新华. 不同病理类型肺部磨玻璃结节的CT诊断. 临床医药文献电子杂志, 2019, 6(15): 152, 165.
12. Mets OM, de Jong PA, Scholten ET, et al. Subsolid pulmonary nodule morphology and associated patient characteristics in a routine clinical population. Eur Radiol, 2017, 27(2): 689-696.
13. Liu G, Li M, Li G, et al. Assessing the blood supply status of the focal ground-glass opacity in lungs using spectral computed tomography. Korean J Radiol, 2018, 19(1): 130-138.
14. Jin X, Zhao SH, Gao J, et al. CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity. Eur Radiol, 2015, 25(9): 2532-2540.
15. Kim H, Goo JM, Kim YT, et al. CT-defined visceral pleural invasion in T1 lung adenocarcinoma: lack of relationship to disease-free survival. Radiology, 2019, 292(3): 741-749.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Accuracy and technical feasibility of mutual corroboration in the diagnosis of pulmonary nodule: A report of 1 368 cases

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