Clinical characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital

Xiaonan Cui; Daiwei Han; Marjolein AHeuvelmans; Yihui Du; Yingru Zhao; Lei Zhang; Harry JMGroen; Geertruida Hde Bock; Monique DDorrius; Matthijs Oudkerk; Rozemarijn Vliegenthart; Zhaoxiang Ye

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Clinical characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital

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Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital.Methods:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively included.The analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign disease.Patient information was collected from hospital records.Results:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were malignant.Compared to benign nodules,malignant nodules were larger(18.0 mm vs.12.5 mm,P<0.001),more often partly solid(16.0%vs.4.7%,P<0.001)and more often spiculated(72.2%vs.41.2%,P<0.001),with higher density in contrast-enhanced CT(67.0 HU vs.57.5 HU,P=0.015).Final diagnosis was based on surgery in 232 out of 314(73.9%)nodules,166 of which were identified as malignant[30(18.1%)stage III or IV]and 66 as benign.In 36 nodules(11.5%),diagnosis was confirmed by biopsy and the remainder verified based on stability of nodule size at follow-up imaging(n=46,14.6%).Among 65 nodules subjected to gene(EGFR)mutation analyses,28(43.1%)cases(EGFR19 n=13;EGFR21 n=15)were identified as EGFR mutant and 37(56.9%)as EGFR wild-type.Prior to surgery,the majority of patients[n=194(83.6%)]received a contrast-enhanced CT scan for staging of both malignant[n=140(84.3%)]and benign[n=54(81.8%)]nodules.Usage of positron emission tomography(PET)-CT was relatively uncommon[n=38(16.4%)].Conclusions:CT-derived nodule assessment assists in diagnosis of small to intermediate-sized malignant pulmonary nodules.Currently,contrast-enhanced CT is commonly used as the sole diagnostic confirmation technique for pre-surgical staging,often resulting in surgery for late-stage disease and unnecessary surgery in cases of benign nodules.

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《癌症生物学与医学：英文版》 |2020年第1期|P.199-207|共9页
作者
Xiaonan Cui; Daiwei Han; Marjolein AHeuvelmans; Yihui Du; Yingru Zhao; Lei Zhang; Harry JMGroen; Geertruida Hde Bock; Monique DDorrius; Matthijs Oudkerk; Rozemarijn Vliegenthart; Zhaoxiang Ye;
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Department of Radiology Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin''s Clinical Research Center for Cancer Tianjin 300060 ChinaDepartment of Radiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Radiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Epidemiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The NetherlandsMedisch Spectrum Twente Department of Pulmonology Enschede 7512 KZ The Netherlands;

Department of Epidemiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Radiology Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin''s Clinical Research Center for Cancer Tianjin 300060 China;

Department of Thoracic Surgery Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Tianjin 300060 China;

Department of Pulmonary Diseases University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Epidemiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Radiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Radiology University of Groningen University Medical Center Groningen Groningen 9713 GZ The Netherlands;

Department of Radiology Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin''s Clinical Research Center for Cancer Tianjin 300060 China;

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原文格式 PDF
正文语种 chi
中图分类肺肿瘤;
关键词
Lung nodule; diagnosis; computed tomography; pathology; China;

机译：肺结核;诊断;计算断层扫描;病理学;中国;

Clinical characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital

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