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韦诗友, 赵珂嘉, 郭成林等. 肺磨玻璃结节的外科诊断和治疗分析——附663例报告[J]. koko体育app 学报（医学版）, 2017, 48(3): 359-362.
引用本文: 韦诗友, 赵珂嘉, 郭成林等. 肺磨窗玻璃结节的内科疾病诊断和医疗定量分析——附663例报表[J]. 四川省大家学报（生物学版）, 2017, 48(3): 359-362.
WEI Shi-you, ZHAO Ke-jia, GUO Cheng-lin. et al. Diagnosis and Surgical Treatment of Lung Ground-glass Opacities：a Review of 663 Cases[J]. Journal of Sichuan University (Medical Sciences), 2017, 48(3): 359-362.
Citation: WEI Shi-you, ZHAO Ke-jia, GUO Cheng-lin. et al. Diagnosis and Surgical Treatment of Lung Ground-glass Opacities：a Review of 663 Cases[J]. Journal of Sichuan University (Medical Sciences), 2017, 48(3): 359-362.

肺磨玻璃结节的外科诊断和治疗分析——附663例报告

Diagnosis and Surgical Treatment of Lung Ground-glass Opacities：a Review of 663 Cases

  • 摘要: 目的总结分析肺CT检查发现的磨玻璃结节(GGO)的外科诊断和治疗特点。方法回顾性纳入2013年1月至2016年12月在koko体育app 华西医院胸外科行手术切除治疗的肺GGO患者，总结其手术前、手术中以及手术后的临床资料，分析GGO的外科诊治特点。结果共纳入663例患者，手术后病理证实为恶性病变者614例，恶性比例为92.6%。良性GGO组病变直径小于恶性GGO组〔（0.8±0.2） cm vs. （1.5±0.8） cm，P<0.001〕。恶性GGO组患者在胸部CT出现边界不清征象的比例高于良性GGO组（93.8% vs. 20.4%，P<0.001），而两组患者在空泡征、胸膜牵拉、毛刺和分叶征象上差异无统计学意义（P>0.05）。652例（98.3%）患者行胸腔镜手术，仅11例（1.7%）患者行开放手术。336例（50.7%）患者行肺叶切除术，226例（34.1%）患者行肺段切除术，101例（15.2%）患者接受肺楔形切除术。共60例（9.0%）患者发生术后并发症，1例（0.2%）患者死亡。结论由经验丰富的医生筛选的GGO病例，恶性病变比例高，可结合患者的病史资料、影像学资料、年龄、身体状况和心理等情况决定是否行手术切除。手术以微创为主，行亚肺叶或肺叶切除，患者可获得良好的治疗效果。  
    Abstract: Objective To retrospectively investigate the clinical characteristics, surgical treatments of the patients with lung ground-glass opacities (GGO). Methods All the patients, who underwent surgical resection of GGO in our department from Jan. 2013 to Dec. 2016 were retrospectively reviewed. The clinicpathological features were analyzed. Results A total of 663 patients were included in this study. The rate of malignancy was 92.6% (614/663). The diameter of GGO in benign group 〔(0.8±0.2) cm〕 was significant smaller than that in malignant group 〔（1.5±0.8） cm〕(P<0.001). The rate of irregular margin in malignant group was far higher than that in benign group (93.8% vs. 20.4%，P<0.001), but other CT signs such as vacuole sign, plural retraction, speculation and lobulation did not show significant difference between the two groups. A total of 652 (98.3%) cases were resected by video-assisted thoracoscopic surgery (VATS), and only 11 (1.7%) cases were resected by thoracotomy. A total of 336 (50.7%) patients underwent lobectomy, 226 (34.1%) underwent segmentectomy and 101 (15.2%) undewent wedge resection. The rate of surgery-related complications was 9.0% (60/663), and one (0.2%) patient died. Conclusion With careful selection of GGO by experienced surgeons, the rate of malignancy is very high. Surgical resection may be recommended for highly suspected malignant cases. Sublobar resection or lobcotomy by VATS can achieve good treatment effect.  
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