title: Lung adenocarcinoma as a solitary pulmonary nodule: prognostic determinants of CT, PET, and histopathologic findings.
abstract: We aimed to retrospectively compare CT, PET, and histopathologic (the extent of bronchioloalveolar carcinoma [BAC] components) findings of solitary pulmonary nodular (SPN) adenocarcinomas of the lung to determine their value as prognostic determinants. We reviewed CT and PET characteristics of tumors and pathologic specimens from 65 consecutive patients who underwent surgical resection for SPN adenocarcinomas. Nodule size and TDR (tumor shadow disappearance rate) were assessed from CT scans, and maximum standardized uptake value (SUVmax) of tumors was measured at PET. On pathologic examination, BAC, non-BAC, and central fibrous scar ratios were quantified. Prognosis was evaluated by noting disease recurrence during a minimum 12-month follow-up period after curative resection. The interrelationships between TDR, SUVmax, BAC, and non-BAC ratio were studied, and relationships between recurrence and various variables were analyzed. The median follow-up time was 33 months, and seven patients (11%) developed disease recurrence after surgical resection. TDR at CT and SUVmax at PET correlated well with pathologic BAC and non-BAC ratios. Between subgroups with and without recurrence, there were significant differences in SUVmax and BAC and non-BAC ratios. Based on univariate survival analyses, pathologic BAC and non-BAC ratios were risk factors significantly related to recurrence, but only high non-BAC ratio remained as an independent factor associated with recurrence in the multivariate analysis (hazard ratio [HR]=0.956, P=0.013). Among the factors examined, pathologic non-BAC ratio is the only independent risk factor for poor prognosis in patients with SPN adenocarcinomas.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-ku, Seoul 135-710, Republic of Korea.
authors.forename: Ho Yun
authors.initials: HY
authors.lastname: Lee
authors.forename: Joungho
authors.initials: J
authors.lastname: Han
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Lee
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Koo
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Jeong
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
authors.forename: Young-Seok
authors.initials: YS
authors.lastname: Cho
authors.forename: Young Mog
authors.initials: YM
authors.lastname: Shim
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.forename: Kwanmien
authors.initials: K
authors.lastname: Kim
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Choi
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed