Dection of early lung cancer in patient with ground-glass opacity (GGO) lung lesion by HRCT in Taiwan

Background: The introduction of HRCT scan for screening has enabled the earlier detection of lung cancer. The Ground-Glass Opacity (GGO) was defined as a hazy increase in lung attenuation without obscuring the underlying bronchial or vascular structures.Most peripherally located lung cancers detected with CT scan have been stage Ia disease, and their surgical outcome has been excellent. Methods: Between July 2006 and December 2011, 256 patients with 308 GGO lung lesions underwent lung resection for lung carcinoma at the China Medical University Hospital in Taiwan. Results: There were 206 lung cancer (114 Adenocarcinoma,80 BAC and 12 others). Most patients' TNM satging were tage I (94%) - including stage IA(88%) and stage IB(6%). The patients were divided into three groups: TypeA: pure GGO, TypeB: mixed GGO with GGO predominance andType C: mixed GGO with solid predominance. Increasing incidence from type A to C (14%, 36%, 63%) were noted in adenocarcinoma patients. Decreasing incidence from type A to C (44%, 39%, 0%) were noted in BAC patients.The incidence of malignance was 67% in all resected nodules. Conclusions: The incidence of adenocarcinoma increased with correlation to the increasing ratio of solid component (GGO type A to type C). The incidence of BAC decreased with correlation to the increasing ratio of solid component. GGO component was related to the presence of BAC and the solid component increased the ratio of adenocarcinoma. Among all malignant pure GGO nodules less than 1 cm, they were almost stage IA (96%) and BACs account for the majority (47%). Limited resection was done in (46%) BAC and no recurrence developed during the follow-up period.