10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Stage I lung adenocarcinoma: the value of quantitative CT in differentiating pathological subtypes and predicting growth of subsolid nodules

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The aim of this study was to investigate feasibility of quantitative computed tomography (CT) measurements in predicting invasiveness and growth of nodular ground glass opacities (nGGOs).

          A set of 203 patients (group A) with nGGOs that were confirmed stage-I adenocarcinomas and 79 patients (group B) with nGGOs that were completely followed up were included. Lesions diameters, volume (VOL), maximum (MAX), mean (MEN), and standard deviation (STD) of CT attenuation were measured. P53 labeling index (LI) was evaluated through immunohistochemistry in group-A patients. Multivariate linear stepwise regressions were performed based on group-A lesions to calculate P53-LI prediction from CT measurements. The receiver operating characteristic (ROC) curve analyses were performed to assess the performance of P53-LI prediction in predicting invasiveness and growth of nGGOs. The Cox regression analysis was conducted to identify correlation between P53-LI Prediction and volume doubling time (VDT) of lesions in group B.

          Diameter, VOL, MEN, STD, and the P53 LI showed significant differences between lesions of different pathological invasiveness ( P < .01). By multivariate linear regressions, MEN and STD were identified as independent variables indicating P53 LI ( P < .001); thus, an equation was established to calculate P53-LI Prediction as: P53 LI Prediction = 0.013 ×  MEN + 0.024 × STD + 9.741 ( R square = 0.411, P < .001). The P53-LI Prediction showed good performance, similar as the actual one, in differentiating pathological invasiveness of nGGOs. In addition, the P53-LI Prediction demonstrated excellent performance in predicting growth of nGGOs (AUC = 0.833, P < .001) and independently forecasted VDT of nGGOs (β = 1.773, P < .001).

          The P53-LI Prediction that was calculated from preoperative quantitative CT measurements of nGGOs indicates lesions’ invasiveness and allows for predicting growth of nGGOs.

          Related collections

          Most cited references26

          • Record: found
          • Abstract: found
          • Article: not found

          Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons.

          To retrospectively compare pure pulmonary ground-glass opacity (GGO) nodules observed on thin-section computed tomography (CT) images with histopathologic findings. The institutional review board approved this study and waived informed consent. Histopathologic specimens were obtained from 53 GGO nodules in 49 patients. CT scans were assessed in terms of nodule size, shape, contour, internal characteristics, and the presence of a pleural tag. The findings obtained were compared with histopathologic results. Differences in thin-section CT findings according to histopathologic diagnoses were analyzed by using the Kruskal-Wallis test or Fisher exact test. Of 53 nodules in 49 patients (20 men, 29 women; mean age, 54 years; range, 29-78 years), 40 (75%) proved to be broncholoalveolar cell carcinoma (BAC) (n=36) or adenocarcinoma with predominant BAC component (n=4), three (6%) atypical adenomatous hyperplasia, and 10 (19%) nonspecific fibrosis or organizing pneumonia. No significant differences in morphologic findings on thin-section CT scans were found among the three diseases (all P>0.05). A polygonal shape (25%, 10 of 40 nodules) and a lobulated or spiculated margin (45%, 18 of 40) in BAC or adenocarcinoma with predominant BAC component were caused by interstitial fibrosis or infiltrative tumor growth. A polygonal shape and a lobulated or spiculated margin were observed in two (20%) and three (30%) of 10 nodules, respectively, in organizing pneumonia/fibrosis were caused by granulation tissue aligned in a linear manner in perilobular regions with or without interlobular septal thickening. About 75% of persistent pulmonary GGO nodules are attributed to BAC or adenocarcinoma with predominant BAC component, and at thin-section CT, these nodules do not manifest morphologic features that distinguish them from other GGO nodules with different histopathologic diagnoses. Copyright (c) RSNA, 2007.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management.

            The purpose of this article is to discuss histologic diagnosis of pure pulmonary ground-glass opacity nodules (GGNs), high-resolution CT (HRCT) findings and pathologic correlation, and management. When pure GGNs are greater than 15 mm in diameter with nodularity or have high pixel attenuation (>-472 HU), the nodules are more likely to be invasive adenocarcinomas. Sublobar resection with a secured safety margin and without nodal dissection is performed for HRCT-suggested pure-GGN invasive adenocarcinomas and has a 100% 5-year survival rate.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Survivin expression quantified by Image Pro-Plus compared with visual assessment.

              Over the past decades, immunohistochemistry has gained significance and already taken a crucial position in diagnosis of diseases and prognosis of patients. However, manual interpretation of immunohistochemistry and reproducibility of the scoring systems can be highly subjective. In the article, the immunohistochemical staining of survivin in 98 rectal cancers was analyzed by using Image Pro-Plus (IPP) [3 parameters: density mean, area sum, and integrated optical density (IOD)] and the results were compared with visual assessment (2 parameters: intensity and percentage). The correlations between the 2 methods were examined, significant correlations were observed between density mean and staining intensity (Spearman correlation coefficient, rs=0.806, P 0.05) by visual assessment. However, by IPP analysis, both the density mean and IOD were higher in better-differentiated cancers than in worse differentiated ones (P=0.02 and 0.03). There was a substantial agreement between the 2 methods. Density mean and IOD of IPP were representative parameters to assess the immunostaining quantification, and increased sensitivity in scoring and provided a more reliable and reproducible analysis of protein expression, especially, more information of the protein expression in relation to clinicopathologic variables can be provided by IPP analysis.
                Bookmark

                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                April 2017
                21 April 2017
                : 96
                : 16
                : e6595
                Affiliations
                [a ]Department of Clinical Laboratory
                [b ]Department of Respiration
                [c ]Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
                Author notes
                []Correspondence: Xianqun Xu, Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, No. 169 in Donghu Road, Wuhan 430071, Hubei Province, P.R. China (e-mail: leometeor0422@ 123456hotmail.com ).
                Article
                MD-D-16-06483 06595
                10.1097/MD.0000000000006595
                5406068
                28422852
                d647eaf0-cad5-4074-8f11-5c0be71a5ffe
                Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 26 October 2016
                : 18 March 2017
                : 22 March 2017
                Categories
                6800
                Research Article
                Diagnostic Accuracy Study
                Custom metadata
                TRUE

                adenocarcinoma,ground glass opacity,high-resolution computed tomography,lung cancer,p53

                Comments

                Comment on this article