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

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

  • 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)
  • 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)
  • Published : 2004.05.01

Abstract

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.

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.

Keywords

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