Journal of Chest Surgery

  • 제37권5호
  • /
  • Pages.423-431
  • /
  • 2004
  • /
  • 2765-1606(pISSN)
  • /
  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

말초 폐 발생 소형 선암에서 화상적 소견과 병리적, 임상적 예후와의 관계

The Correlation between Radiologic Findings and Clinicopathological Prognostic Factors in Small Peripheral Adenocarcinoma of Lung

  • 박재길 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 조규도 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 박건 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 문석환 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 나석주 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 최시영 (가톨릭대학교 의과대학 성모병원 흉부외과학교실, 가톨릭중앙의료원 암센터) ;
  • 정정임 (가톨릭대학교 의과대학 성모병원 진단방사선과학교실)
  • Park, Jae-Kil (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Cho, Kyu-Do (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Park, Kuhn (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Moon, Seok-Whan (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Rha, Suk-Joo (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Choi, Si-Young (Dept. of Thoracic and Cardiovascular Surgery, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Catholic Cancer Center) ;
  • Jung, Jung-Im (Dept. of Radiology, St. Mary's Hospital, College of Medicine, Catholic University of Korea)
  • 발행 : 2004.05.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

배경 : 폐 말초발생의 소형 선암은 타 조직형태의 폐암들과는 달리 종양의 크기가 예후와 밀접한 관계를 보이지 않아 예후의 예측이 어려운데, 최근 예후와 관련이 있는 화상적 소견들이 보고되고 있다. 이에 저자들은 절제된 소형 폐선암에서 병리적 소견과 예후를 분석하여 화상적 소견들과의 관계를 알아보고자 하였다. 대상 및 방법: 절제술을 시행 받았던 말초 폐 발생 소형 선암증례 중 종양의 최대경이 3cm 이하인 176예를 대상으로 수술 전 HRCT상의 소견들을 분석하였으며, 이들 소견과 병리학적 그리고 임상적 예후인자들과의 관계를 분석하였다. 결과: GGA의 정도가 큰 암일수록 병리학적 그리고 임상적으로 양호한 예후인자를 보였다. 또한 종양의 육안적인 형태에 따른 분류에서도 GGA형 혹은 bubble-like형이 scar-like형 혹은 solid형에 비하여 병리학적 그리고 임상적으로 양호한 예후인자를 나타내었다. 결론: 말초 폐의 소형 선암에서 HRCT 소견은 병리학적 그리고 임상적 예후인자들과 밀접한 관계가 있음이 확인되어, 화상적인 소견에 의하여 절제술 후의 예후를 예측할 수 있을 것으로 생각된다.

Background : Tumor size in lung cancer is not as good a prognostic factor for adenocarcinoma as it is for other types of lung cancer; therefore it is difficult to estimate the prognosis preoperative. However, there have recently been some reports on the radiologic findings correlating to the clinicopathologic prognostic factors in peripheral small adenocarcinoma of lung. We tried to evaluate the prognostic importance of High-Resolution CT (HRCT) findings of such adenoearcinoma, Material and Method: One houndred and seventy-six surgically resected small peripheral adenocarcinoma measuring 3 cm or less in greatest dimension were reviewed radiologically and clinicopathologically. Result: The patients with greater extent of ground-glass attenuation (GGA) had better clinico-pathological factors. The tumors with gross appearance of GGA or bubble-like shape showed better clinicopathological prognostic factors than scar-like or solid shape. Conclusion: HRCT findings of small peripheral adenocarcinomas of the lung correlated well with the histologic and clinical prognostic factors. We can predict the post-operative prognosis with the radiologic findings.

키워드

참고문헌

  1. J Korean Cancer Assoc v.34 Epidemiology of lung cancer in Korea Lee,C.T.
  2. Am J Surg Pathol v.4 Prognostic implication of fibrotic focus (scar) in small peripheral lung cancer Shimosato,Y.;Suzuki,A.;Hashimoto,T.(et al.) https://doi.org/10.1097/00000478-198008000-00005
  3. Cancer v.54 Prognostic factors in patients with resected stage I non-small cell lung cancer:a report from the lung cancer study group Gail,M.H.;Eagan,R.T.;Feld,R.(et al.) https://doi.org/10.1002/1097-0142(19841101)54:9<1802::AID-CNCR2820540908>3.0.CO;2-4
  4. Radiology v.223 Volumetric growth rate of stage I lung cancer prior to treatment:Serial CT scanning Winer-Muran,H.T.;Jennings,S.G.;Tarver,R.D.(et al.) https://doi.org/10.1148/radiol.2233011026
  5. Histological typing of lung and pleural tumours, World Health Organization International Histological Classification of Tumours(3rd edition) Travis,W.D.;Colby,T.V.;Corrin,B.(et al.)
  6. Morphogenesis of lung cancer Morphogenesis of peripheral type adenocarcinoma of the lung Shimosato,Y.;Kodama,T.;Kameya,T.;Shimosato,Y.(ed.);Melamed,M.R.(ed.);Nettesheim,P.(ed.)
  7. Cancer v.75 Small adenocarcinoma of the lung: Histologic characteristics and prognosis Noguchi,M.;Morikawa,A.;Kawasaki,M.(et al.) https://doi.org/10.1002/1097-0142(19950615)75:12<2844::AID-CNCR2820751209>3.0.CO;2-#
  8. J Thorac Cardiovasc Surg v.111 Lymph node involvement, recurrence, and prognosis in resected small, peripheral, non-small-cell lung carcinomas:are these carcinoma candidates for video-assisted lobectomy? Asamura,H.;Nakayama,H.;Kondo,H.(et al.) https://doi.org/10.1016/S0022-5223(96)70213-1
  9. Cancer v.77 The changes of the stromal elastotic framework in the growth of peripheral lung adenocarcinomas Eto,T.;Suzuki,H.;Honda,A.;Nagashima,Y. https://doi.org/10.1002/(SICI)1097-0142(19960215)77:4<646::AID-CNCR10>3.0.CO;2-0
  10. Jpn J Diagnostic Imaging v.21 Radiologic-pathologic correlation of small adenocarcinomas of the lung Koizumi,N.;Morita,T.;Sakai,K.(et al.)
  11. AJR v.180 CT findings and progression of small peripheral lung neoplasms having a replacement growith pattern Takashima,S.;Maruyama,Y.;Hasegawa,M.(et al.) https://doi.org/10.2214/ajr.180.3.1800817
  12. Radiology v.220 Peripheral lung adenoarcinoma:Correlation of thin-section CT findings with histologic prognostic factors and survival Aoki,T.;Tomoda,Y.;Watanabe,H.(et al.) https://doi.org/10.1148/radiol.2203001701
  13. Jpn J Diagnostic Imaging v.21 Pathology of lung cancer for radiologists Ohbayashi,C.
  14. AJR v.156 Prevalence of air-bronchograms in small peripheral carcinoma of the lung on thin-section CT:comparison with benign tumors Kuriyama,K.;Tateishi,R.;Doi,O.(et al.) https://doi.org/10.2214/ajr.156.5.2017952
  15. AJR v.177 Quantification of ground-glass opacity on high-resolution CT of small peripheral adenocarcinoma of the lung Kim,E.A.;Johkoh,T;Lee,K.S.(et al.) https://doi.org/10.2214/ajr.177.6.1771417
  16. Ann Thorac Surg v.68 Prognostic valve of broncho-alveolar carcinoma component of small lung adenocarcinoma Higashiyama,M.;Kodama,K.;Yokouchi,H.(et al.) https://doi.org/10.1016/S0003-4975(99)01064-4
  17. Ann Thorac Surg v.60 Randomized trial of lobectomy versus limited resection for T1 NO non-small cell lung cancer Ginsberg,R.J.;Rubinstein,L.V.
  18. Jpn J Lung Cancer Clin v.4 Selection of suitable operation method based on HRCT findings of peripheral small-sized lung cancer Kodama,K.;Higashiyama,M.;Takami,K.;Higaki,N.;Yokouchi,H.
  19. Text book of pulmonary diseases(4th ed.) Bronchogenic carcinoma Bruderman,I.;Baum,G.L.;Wolinsky,E.
  20. Jpn J Lung Cancer Clin v.4 CT findindgs of chest X-ray undetectable peripheral bronchogenic carcinoma and of borderline diseases Kusumoto,M.;Tateishi,U.;Kaneko,M.;Moriyama,N.