Ground glass nodules in the lungs

The lungs are a particularly important organ in our body, but this organ is prone to many diseases, such as ground-glass nodules in the lungs. Many people have never heard of this, let alone their understanding of it. But no matter who you are, ground-glass nodules in the lungs are a very serious lung disease. If you want to learn about this disease, you can read the introduction below.

Simply put, ground-glass nodules are a type of lesion that can only be detected on thin-layer CT scans of the lungs. There are many types of lung diseases that can manifest as this type of disease on CT, the most common of which are inflammation and some early lung cancers. It should be pointed out that lung cancer that appears as ground-glass nodules on CT is usually classified as pre-invasive lesions (adenocarcinoma in situ, microinvasive adenocarcinoma) in medicine, which means that the alveolar epithelial cells have just undergone malignant transformation and have not yet grown in a large number of invasive ways into the lung interstitium. In contrast, traditional lung cancer is mostly invasive lung cancer, which appears as a solid nodule larger than 25px or a larger mass on CT. Its malignancy is far greater than adenocarcinoma in situ or microinvasive adenocarcinoma that appears as ground-glass nodules. According to large sample statistics from home and abroad, adenocarcinoma in situ is almost a disease that can be cured by surgery, and the surgical treatment effect of microinvasive adenocarcinoma is similar to that of adenocarcinoma in situ.

The next question is, how to determine what kind of disease the ground-glass nodules in the lungs are, and is surgery necessary once they are discovered? We recommend that healthy people undergo a low-dose lung CT scan at a Class A tertiary hospital during their annual physical examination. Its radiation dose is only 1/3 of that of a regular CT scan, and it is a thin-layer scan, which can effectively detect tiny lesions in the lungs. Once a problem is discovered, the patient needs to go to a specialist clinic in the thoracic surgery or respiratory department. The doctor needs to carefully check the various characteristics of the lesions on the computer, and make a comprehensive judgment based on size, shape, density, etc., and judge whether the ground-glass nodules have the characteristics of early tumors based on clinical experience. For lesions that are highly suspected of being tumors, the patient will be recommended to undergo surgical resection or close follow-up (about 3 months). For lesions whose characteristics do not match those of a tumor, patients will be advised to undergo CT follow-up observation every six months to one year. Why is the follow-up interval so long? The reason is that the growth of pre-invasive lung cancer is very slow. According to foreign statistics, the time it takes for adenocarcinoma in situ to double in size (i.e., the lesion doubling time) is 680 days, which is close to 2 years. Therefore, too frequent follow-up will not reveal any changes in the lesions. Some people may ask, will ground-glass nodules definitely develop into early lung cancer? The answer is no. We have found in clinical practice that the ground-glass nodules in the lungs of many people may not change after many years of follow-up. For nodules that do not meet the characteristics of early-stage tumors, surgical resection is not necessary.

In summary, regular physical examinations and timely surgical resection of lung lesions when they have the characteristics of early tumors are the key to early diagnosis and treatment of lung cancer. Therefore, it is particularly important to find an experienced physician for timely follow-up. In 2015, the Department of Thoracic Surgery of Renji Hospital performed nearly 700 resections of ground-glass nodules in the lungs. Among them, in nearly 90% of the patients, the physician's diagnosis before surgery and the final pathological diagnosis after resection were completely consistent. In other words, the nature of the lesions could be correctly diagnosed in 90% of the patients before surgery. More than 90% of patients undergo minimally invasive thoracoscopic surgery, recover quickly, and stay in the hospital for about 4 to 5 days after surgery. Therefore, we are confident to tell our friends that ground-glass nodules in the lungs need to be taken seriously, but there is no need to be afraid of them.