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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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Cancer Biology & Medicine 2020年第1期17卷 199-207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 Department of Radiology Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin's Clinical Research Center for CancerTianjin 300060China Department of Radiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Epidemiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Medisch Spectrum Twente Department of PulmonologyEnschede 7512 KZThe Netherlands Department of Thoracic Surgery Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin’s Clinical Research Center for CancerTianjin 300060China Department of Pulmonary Diseases University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands University of Groningen University Medical Center GroningenGroningen 9713 GZThe Netherlands

Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer ***:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively *** analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign *** information was collected from hospital ***:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were *** 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 *** 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 *** 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%)]*** 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 ***,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.

关键词： Lung nodule diagnosis computed tomography pathology China

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