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. 2019 Jul;10(7):1544-1551.
doi: 10.1111/1759-7714.13098. Epub 2019 Jun 2.

Risk factors associated with an increase in the size of ground-glass lung nodules on chest computed tomography

Hee-Young Yoon  1 , Ji-Yun Bae  1 , Yookyung Kim  2 , Sung Shin Shim  2 , Sojung Park  1 , So-Young Park  1 , Soo Jung Kim  1 , Yon Ju Ryu  1 , Jung Hyun Chang  1 , Jin Hwa Lee
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Risk factors associated with an increase in the size of ground-glass lung nodules on chest computed tomography

Hee-Young Yoon et al. Thorac Cancer. 2019 Jul.

Abstract

Background: The detection rate of ground-glass nodules (GGNs) in the lung has increased with the increased use of low-dose computed tomography (CT) of the chest for cancer screening; however, limited data is available on the natural history, follow-up, and treatment of GGNs. The aim of this study was to identify factors associated with an increase in the size of GGNs.

Methods: A total of 338 patients (mean ages, 59.8 years; males, 35.5%) with 689 nodules who underwent chest CT at our institute between June 2004 and February 2014 were included in this study. The cut-off date of follow-up was August 2018. We analyzed the size, solidity, number, and margins of the nodules compared with their appearance on previous chest CT images. The Cox proportional hazard model was used to identify risk factors associated with nodule growth.

Results: The median follow-up period was 21.8 months. Of the 338 patients, 38.5% had a history of malignancy, including lung cancer (8.9%). Among the 689 nodules, the median size of the lesions was 6.0 mm (IQR, 5-8 mm), and the proportion of nodules with size ≥10 mm and multiplicity was 17.1% and 66.3%, respectively. Compared to the nodules without an increase in size, the 79 nodules with an increase in size during the follow-up period were initially larger (growth group, 7.0 mm vs. non-growth group, 6.0 mm; P = 0.027), more likely to have a size ≥10 mm (26.6% vs. 15.9%; P = 0.018), and had less frequent multiplicity (54.4% vs. 67.9%, P = 0.028). In the multivariate analysis, nodule size ≥10 mm (hazard ratio [HR], 2.044; P = 0.005), a patient history of lung cancer (HR: 2.190, P = 0.006), and solitary nodule (HR: 2.499, P < 0.001) were independent risk factors for nodule growth.

Conclusion: Careful follow-up of GGNs is warranted in patients with a history of malignancy, a large , or a solitary nodule.

Keywords: Ground glass lung nodules; low-dose computed tomography; lung cancer; prognosis; screening.

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Figures

Figure 1
Figure 1
Enrollment of patients. GGNs, ground‐glass nodules.
Figure 2
Figure 2
Kaplan‐Meier curves of increases in ground‐glass nodules size according to nodule size (a), multiplicity (b), the presence of a solid portion (c) and ill‐defined margin (d)
See this image and copyright information in PMC

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