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*Only for medical professionals to read for reference.
According to the eighth edition of TNM staging, what effect does GGO component have on the prognosis of patients? Research background The eighth edition of TNM staging provides a more detailed classification of early stage non-small cell lung cancer (NSCLC).
Early stage lung cancer is divided into IA1-IB according to tumor size, and it is recommended to use imaging and pathological examination results as the judgment of tumor.
The basis of size.
Due to the widespread use of thin-slice computed tomography (TSCT, thin-slice CT), more and more early lung cancers containing ground glass (GGO) components have been diagnosed [1].
The GGO component in thin-slice CT usually corresponds to the growth of squamous cell components, while the solid component corresponds to the infiltrating component, alveolar collapse, and mucin deposition in the pathological examination [2].
Many previous studies have confirmed that GGO often predicts a good postoperative prognosis for patients with lung cancer [3-5].
Therefore, it is reasonable and feasible for T classification to judge tumor invasion and OS (overall survival) only based on the size of solid components of thin-slice CT, but there are also certain problems.
For example, it is still difficult to use CT to judge the size of solid components.
Etc.
[6].
In order to clarify the influence of the GGO component in the eighth edition of the TNM staging on the prognosis of patients and to propose a more accurate stage for predicting the prognosis of patients, Professor Masahiro Tsuboi from Japan and others retrospectively analyzed the National Cancer Center of Japan in 2003.
Surgical database from January to December 2011, and the results were published in the Journal of Thoracic Oncology [7].Research methods The study screened 2013 surgical patients, of which 1866 received lobectomy and systemic lymph node dissection, and excluded patients with neoadjuvant therapy, poorly differentiated tumors, distant metastases, and sublobectomy before surgery, and were finally included Among 1290 patients with stage 0-IB stage, among adenocarcinoma patients, the demographic characteristics and overall survival of with/without GGO components were compared, and the distribution of histological subtypes with/without GGO components in each clinical stage (squamous Cancer and other types are compared based on clinical stage).
In adenocarcinoma, subjects are evaluated every 3 months for the first 2 years and every 6 months after 2 years.
Use enhanced CT of the chest and upper abdomen to assess the clinical stage, and use thin-slice CT to assess the size of the primary tumor, GGO composition, solid composition and other factors.
The surgical specimens were stained with elastica van Gieson or Victoria blue-van Gieson to evaluate the infiltration of blood vessels and pleura.
The histological classification is based on the third edition of the WHO cytological classification and the fourth edition is used for re-evaluation.
Overall survival is defined as the time from surgery to the last follow-up or death from all causes.
The results of the study were followed up for a median of 8.
6 years, and about half of the 1290 patients included were male patients [n=755 (59%), 483 had no history of smoking (37%)].
Most patients [n=949 (74%)] preoperative carcinoembryonic antigen (CEA) level is 5 ng/mL and below.
The longest diameter of the tumor (including the GGO component) averaged 25±8 mm, and the size of the solid tumor component was 22±10 mm.
GGO components were detected in 35% of patients.
2% of patients were in Tis stage (stage 0, n=21, defined as lung tumors with no solid imaging components and size ≤3cm).
The number of patients in stage IA1, IA2, IA3, and IB was 152 (12%).
435 (34%), 413 (32%) and 269 (21%).
The subjects were mainly adenocarcinoma, accounting for 78% (1012/1290), including 29 cases of AIS (adenocarcinoma in situ) and 94 cases of MIA (micro-invasive adenocarcinoma).
Among 867 cases of invasive adenocarcinoma, 231 cases were scaly growth, 128 cases were mainly acinar-like, 325 cases were mainly papillary, 14 cases were mainly micropapillary, and 169 cases were mainly solid.
Among the adenocarcinoma subtypes, there were 2 invasive mucinous adenocarcinomas, 17 invasive/non-mucinous mixed adenocarcinomas, 1 colloidal adenocarcinoma, and 2 fetal adenocarcinomas.
Among 1012 adenocarcinoma patients, squamous cell components were detected in 778 cases (77%).
28 cases (2%) in pTis stage (pathological stage 0), the number of patients with pathological stages IA1, IA2, IA3 and IB were 262 (20%), 330 (26%), 207 (16%) and 230 (18%), respectively .
The number of patients with pathological stages IA, IIB, IIIA, and IIIB were 22 (2%), 91 (7%), 107 (8%), and 13 (1%), respectively.
1.
The 5-year survival rate of early stage lung cancer is generally good.
Clinical stage 0, IA1, IA2, IA3, and IB stages are 100%, 95%, 84%, 76%, and 65%, respectively (Figure 1).
Figure 1 Overall survival curves of different clinical stages The overall survival of patients with adenocarcinoma in clinical stages IA2 and IA3 is better than that of patients with squamous cell carcinoma, but there is no statistical difference in survival between patients with stage IB adenocarcinoma and squamous cell carcinoma (Figure 2).
Figure 2 Overall survival curve of each clinical stage histological subtype Clinical stage IA patients with GGO-containing adenocarcinoma have better overall survival, stage IB patients with GGO-containing adenocarcinoma, adenocarcinoma without GGO, and squamous cell carcinoma There was no difference in overall survival (Figure 3).
Figure 3 Survival curve of patients with/without GGO 2.
Patients with/without GGO components have different postoperative pathology.
In clinical 0~IA3, 50% of the histological subtypes of adenocarcinoma patients containing GGO components are in situ Adenocarcinoma, microinvasive adenocarcinoma and squamous cell-based invasive adenocarcinoma (stage 0 16/21; IA1 stage 113/143; IA2 stage 80/157; IA3 stage 45/94) (Table 1). Table 1 Distribution of histological subtypes of GGO adenocarcinoma Most patients without GGO adenocarcinoma are clinically staged IA2~IB.
The histological subtype is mainly acinar-like, and invasive adenocarcinoma and solid-based invasive adenocarcinoma are more common.
Table 2 Distribution of histological subtypes of GGO-free adenocarcinoma 3.
The OS of patients with GGO component is higher than that of patients without GGO component, but excluding patients with stage IB.
In clinical stage IA, about 50% of GGO adenocarcinoma patients ( Solid size <3 cm) histological type is mainly squamous cell invasive adenocarcinoma, and the incidence is higher than that of patients without GGO adenocarcinoma.
In addition, the incidence of solid-type invasive adenocarcinoma in patients without GGO is higher than that in patients with adenocarcinoma with GGO.
Histological subtypes suggest that there is a big difference in the survival rate of lung cancer patients with and without GGO.
However, in clinical stage IB, the histological subtype distribution and prognosis of patients with lung adenocarcinoma with GGO are similar to the histological subtype distribution and prognosis of patients with lung adenocarcinoma without GGO (solid size ≥ 3 cm), and the two survival curves are also It is getting closer and closer to the survival curve of patients with squamous cell carcinoma.
The components of solid adenocarcinoma are related to lymph node metastasis, vascular invasion and pleural invasion, and the prognosis is poor.
In some solid nodules, the solid components on TSCT mainly correspond to pathological alveolar collapse and/or fibrosis.
However, in lung nodules without GGO, the solid components in TSCT mainly correspond to infiltrating subtypes (acinoid, mastoid, micropapilla, and solid).
Collapse and/or fibrosis can also be found in some lung nodules without GGO, but the size of collapse and/or fibrosis in GGO-free adenocarcinoma is significantly smaller than that in lung adenocarcinoma with GGO.
In each clinical stage, the prognosis of patients with adenocarcinoma without squamous cell component is worse than that of any other stage, suggesting that adenocarcinoma without squamous cell component is highly malignant lung cancer.
When grouped according to pathological stages, there is no significant difference between the survival curves of adenocarcinoma patients with squamous cell components in pathology and the survival curves of adenocarcinoma patients without squamous cell components in each pathological stage.
This shows that compared with clinical staging, the prognostic group of pathological staging is better.
Summary of the study The study further confirmed that the eighth edition of the TNM staging standard recommended that T staging based on imaging or pathological results is effective and feasible.
In addition, the study also shows that the prognosis of lung cancer patients with different histological subtypes of the same stage is different.
It is recommended that the next version of TNM staging T descriptions include the presence or absence of GGO, which can more accurately predict the prognosis of lung cancer patients with tumors less than 3 cm in size.
Translation review expert Professor Liang Junguo Chief physician, Ph.
D.
, Master Supervisor, Deputy Director of Thoracic Surgery, Affiliated Hospital of Inner Mongolia Medical University, Member of Esophageal Cancer Group, Chinese Medical Association Thoracic Surgery Branch, Member of Lung Cancer Professional Committee, Chinese Anti-Cancer Association, Inner Mongolia Medical Association Member of the Standing Committee of the Surgery Branch of the Inner Mongolia Medical Association Thoracic Surgery Branch of the Standing Committee of the translation review expert Professor Wang Hao Chief physician, Director of the Department of Oncology and Thoracic Surgery, Baotou Tumor Hospital, Ph.
D.
student at Tianjin Medical University, Standing Committee of the Inner Mongolia Medical Association Thoracic Tumor Committee Standing Committee, Inner Mongolia Anti-Cancer Association Lung Cancer Professional Committee Member of the Chinese Anti-Cancer Association CSCO Member of the Chinese Research Hospital Association Precision Medicine and Tumor MDT Professional Committee Lung Cancer Group Member of the Beijing Medical Association Award Foundation Lung Cancer Medical Association Youth Member Wu Jieping Foundation Simulation Medicine Thoracic Surgery Committee Member, Baotou City Lung Cancer Professional Committee Member 2015 Baotou famous doctor reserve talent reference: [1] Ma Yong, et al.
Clinical analysis of 53 cases of single-port thoracoscopic resection of pulmonary ground glass nodules.
Chinese Medicines and Clinics.
2020, 20 (17): 2891-93.
[2 ]Travis WD, et al.
The IASLC lung cancer staging project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer.
J Thorac Oncol.
2016 ;11:1204–1223.
[3]Kodama K, et al.
Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning.
Lung Cancer.
2001;33:17–25.
[4]Aokage K, et al.
Identification of early T1B lung adenocarcinoma based on thin-section computed tomography findings.
J Thorac Oncol.
2013;8:1289–1294.
[5]Aoki T, et al.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery , Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non–Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
According to the eighth edition of TNM staging, what effect does GGO component have on the prognosis of patients? Research background The eighth edition of TNM staging provides a more detailed classification of early stage non-small cell lung cancer (NSCLC).
Early stage lung cancer is divided into IA1-IB according to tumor size, and it is recommended to use imaging and pathological examination results as the judgment of tumor.
The basis of size.
Due to the widespread use of thin-slice computed tomography (TSCT, thin-slice CT), more and more early lung cancers containing ground glass (GGO) components have been diagnosed [1].
The GGO component in thin-slice CT usually corresponds to the growth of squamous cell components, while the solid component corresponds to the infiltrating component, alveolar collapse, and mucin deposition in the pathological examination [2].
Many previous studies have confirmed that GGO often predicts a good postoperative prognosis for patients with lung cancer [3-5].
Therefore, it is reasonable and feasible for T classification to judge tumor invasion and OS (overall survival) only based on the size of solid components of thin-slice CT, but there are also certain problems.
For example, it is still difficult to use CT to judge the size of solid components.
Etc.
[6].
In order to clarify the influence of the GGO component in the eighth edition of the TNM staging on the prognosis of patients and to propose a more accurate stage for predicting the prognosis of patients, Professor Masahiro Tsuboi from Japan and others retrospectively analyzed the National Cancer Center of Japan in 2003.
Surgical database from January to December 2011, and the results were published in the Journal of Thoracic Oncology [7].Research methods The study screened 2013 surgical patients, of which 1866 received lobectomy and systemic lymph node dissection, and excluded patients with neoadjuvant therapy, poorly differentiated tumors, distant metastases, and sublobectomy before surgery, and were finally included Among 1290 patients with stage 0-IB stage, among adenocarcinoma patients, the demographic characteristics and overall survival of with/without GGO components were compared, and the distribution of histological subtypes with/without GGO components in each clinical stage (squamous Cancer and other types are compared based on clinical stage).
In adenocarcinoma, subjects are evaluated every 3 months for the first 2 years and every 6 months after 2 years.
Use enhanced CT of the chest and upper abdomen to assess the clinical stage, and use thin-slice CT to assess the size of the primary tumor, GGO composition, solid composition and other factors.
The surgical specimens were stained with elastica van Gieson or Victoria blue-van Gieson to evaluate the infiltration of blood vessels and pleura.
The histological classification is based on the third edition of the WHO cytological classification and the fourth edition is used for re-evaluation.
Overall survival is defined as the time from surgery to the last follow-up or death from all causes.
The results of the study were followed up for a median of 8.
6 years, and about half of the 1290 patients included were male patients [n=755 (59%), 483 had no history of smoking (37%)].
Most patients [n=949 (74%)] preoperative carcinoembryonic antigen (CEA) level is 5 ng/mL and below.
The longest diameter of the tumor (including the GGO component) averaged 25±8 mm, and the size of the solid tumor component was 22±10 mm.
GGO components were detected in 35% of patients.
2% of patients were in Tis stage (stage 0, n=21, defined as lung tumors with no solid imaging components and size ≤3cm).
The number of patients in stage IA1, IA2, IA3, and IB was 152 (12%).
435 (34%), 413 (32%) and 269 (21%).
The subjects were mainly adenocarcinoma, accounting for 78% (1012/1290), including 29 cases of AIS (adenocarcinoma in situ) and 94 cases of MIA (micro-invasive adenocarcinoma).
Among 867 cases of invasive adenocarcinoma, 231 cases were scaly growth, 128 cases were mainly acinar-like, 325 cases were mainly papillary, 14 cases were mainly micropapillary, and 169 cases were mainly solid.
Among the adenocarcinoma subtypes, there were 2 invasive mucinous adenocarcinomas, 17 invasive/non-mucinous mixed adenocarcinomas, 1 colloidal adenocarcinoma, and 2 fetal adenocarcinomas.
Among 1012 adenocarcinoma patients, squamous cell components were detected in 778 cases (77%).
28 cases (2%) in pTis stage (pathological stage 0), the number of patients with pathological stages IA1, IA2, IA3 and IB were 262 (20%), 330 (26%), 207 (16%) and 230 (18%), respectively .
The number of patients with pathological stages IA, IIB, IIIA, and IIIB were 22 (2%), 91 (7%), 107 (8%), and 13 (1%), respectively.
1.
The 5-year survival rate of early stage lung cancer is generally good.
Clinical stage 0, IA1, IA2, IA3, and IB stages are 100%, 95%, 84%, 76%, and 65%, respectively (Figure 1).
Figure 1 Overall survival curves of different clinical stages The overall survival of patients with adenocarcinoma in clinical stages IA2 and IA3 is better than that of patients with squamous cell carcinoma, but there is no statistical difference in survival between patients with stage IB adenocarcinoma and squamous cell carcinoma (Figure 2).
Figure 2 Overall survival curve of each clinical stage histological subtype Clinical stage IA patients with GGO-containing adenocarcinoma have better overall survival, stage IB patients with GGO-containing adenocarcinoma, adenocarcinoma without GGO, and squamous cell carcinoma There was no difference in overall survival (Figure 3).
Figure 3 Survival curve of patients with/without GGO 2.
Patients with/without GGO components have different postoperative pathology.
In clinical 0~IA3, 50% of the histological subtypes of adenocarcinoma patients containing GGO components are in situ Adenocarcinoma, microinvasive adenocarcinoma and squamous cell-based invasive adenocarcinoma (stage 0 16/21; IA1 stage 113/143; IA2 stage 80/157; IA3 stage 45/94) (Table 1). Table 1 Distribution of histological subtypes of GGO adenocarcinoma Most patients without GGO adenocarcinoma are clinically staged IA2~IB.
The histological subtype is mainly acinar-like, and invasive adenocarcinoma and solid-based invasive adenocarcinoma are more common.
Table 2 Distribution of histological subtypes of GGO-free adenocarcinoma 3.
The OS of patients with GGO component is higher than that of patients without GGO component, but excluding patients with stage IB.
In clinical stage IA, about 50% of GGO adenocarcinoma patients ( Solid size <3 cm) histological type is mainly squamous cell invasive adenocarcinoma, and the incidence is higher than that of patients without GGO adenocarcinoma.
In addition, the incidence of solid-type invasive adenocarcinoma in patients without GGO is higher than that in patients with adenocarcinoma with GGO.
Histological subtypes suggest that there is a big difference in the survival rate of lung cancer patients with and without GGO.
However, in clinical stage IB, the histological subtype distribution and prognosis of patients with lung adenocarcinoma with GGO are similar to the histological subtype distribution and prognosis of patients with lung adenocarcinoma without GGO (solid size ≥ 3 cm), and the two survival curves are also It is getting closer and closer to the survival curve of patients with squamous cell carcinoma.
The components of solid adenocarcinoma are related to lymph node metastasis, vascular invasion and pleural invasion, and the prognosis is poor.
In some solid nodules, the solid components on TSCT mainly correspond to pathological alveolar collapse and/or fibrosis.
However, in lung nodules without GGO, the solid components in TSCT mainly correspond to infiltrating subtypes (acinoid, mastoid, micropapilla, and solid).
Collapse and/or fibrosis can also be found in some lung nodules without GGO, but the size of collapse and/or fibrosis in GGO-free adenocarcinoma is significantly smaller than that in lung adenocarcinoma with GGO.
In each clinical stage, the prognosis of patients with adenocarcinoma without squamous cell component is worse than that of any other stage, suggesting that adenocarcinoma without squamous cell component is highly malignant lung cancer.
When grouped according to pathological stages, there is no significant difference between the survival curves of adenocarcinoma patients with squamous cell components in pathology and the survival curves of adenocarcinoma patients without squamous cell components in each pathological stage.
This shows that compared with clinical staging, the prognostic group of pathological staging is better.
Summary of the study The study further confirmed that the eighth edition of the TNM staging standard recommended that T staging based on imaging or pathological results is effective and feasible.
In addition, the study also shows that the prognosis of lung cancer patients with different histological subtypes of the same stage is different.
It is recommended that the next version of TNM staging T descriptions include the presence or absence of GGO, which can more accurately predict the prognosis of lung cancer patients with tumors less than 3 cm in size.
Translation review expert Professor Liang Junguo Chief physician, Ph.
D.
, Master Supervisor, Deputy Director of Thoracic Surgery, Affiliated Hospital of Inner Mongolia Medical University, Member of Esophageal Cancer Group, Chinese Medical Association Thoracic Surgery Branch, Member of Lung Cancer Professional Committee, Chinese Anti-Cancer Association, Inner Mongolia Medical Association Member of the Standing Committee of the Surgery Branch of the Inner Mongolia Medical Association Thoracic Surgery Branch of the Standing Committee of the translation review expert Professor Wang Hao Chief physician, Director of the Department of Oncology and Thoracic Surgery, Baotou Tumor Hospital, Ph.
D.
student at Tianjin Medical University, Standing Committee of the Inner Mongolia Medical Association Thoracic Tumor Committee Standing Committee, Inner Mongolia Anti-Cancer Association Lung Cancer Professional Committee Member of the Chinese Anti-Cancer Association CSCO Member of the Chinese Research Hospital Association Precision Medicine and Tumor MDT Professional Committee Lung Cancer Group Member of the Beijing Medical Association Award Foundation Lung Cancer Medical Association Youth Member Wu Jieping Foundation Simulation Medicine Thoracic Surgery Committee Member, Baotou City Lung Cancer Professional Committee Member 2015 Baotou famous doctor reserve talent reference: [1] Ma Yong, et al.
Clinical analysis of 53 cases of single-port thoracoscopic resection of pulmonary ground glass nodules.
Chinese Medicines and Clinics.
2020, 20 (17): 2891-93.
[2 ]Travis WD, et al.
The IASLC lung cancer staging project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer.
J Thorac Oncol.
2016 ;11:1204–1223.
[3]Kodama K, et al.
Prognostic value of ground-glass opacity found in small lung adenocarcinoma on high-resolution CT scanning.
Lung Cancer.
2001;33:17–25.
[4]Aokage K, et al.
Identification of early T1B lung adenocarcinoma based on thin-section computed tomography findings.
J Thorac Oncol.
2013;8:1289–1294.
[5]Aoki T, et al.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery , Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non–Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Peripheral lung adenocarcinoma: correlation of thin-section CT findings with histologic prognostic factors and survival.
Radiology 2001;220:803–809.
[6]Takeshi Matsunaga, et al.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Lung cancer with scattered consolidation: detection of new independent radiological category of peripheral lung cancer on thin-section computed tomography.
Interactive CardioVascular and Thoracic Surgery, Volume 16, Issue 4, April 2013, Pages 445–449.
[7]Keiju Aokage, et al.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
Influence of Ground Glass Opacity and the Corresponding Pathological Findings on Survival in Patients with Clinical Stage I Non--Small Cell Lung Cancer.
Journal of Thoracic Oncology.
2018;Vol.
13 No.
4: 533-542.
