Zhongguo linchuang yanjiu (Jan 2024)
Clinical and molecular pathological characteristics of 371 cases of malignant pulmonary nodules
Abstract
Objective: To summarize the clinical and molecular pathological characteristics of malignant pulmonary nodules and improve understanding of the disease. Methods: Patients who underwent surgical resection of small pulmonary nodules in Cardiothoracic Surgery of Jiangsu Province Hospital of Chinese Medicine from March 2018 to December 2021 and were pathologically confirmed to be malignant were taken as the research objects. Retrospective analysis of clinical data and molecular pathological features of surgical specimens was conducted. Results: A total of 371 patients were enrolled, including 39 cases of carcinoma in situ (CIS), 164 cases of microinvasive adenocarcinoma (MIA) and 168 cases were invasive adenocarcinoma (IA); 69.8% were females, 30.2% were males, with a majority of females. 87.6% of patients did not smoke; The upper lobe of the right lung had the most malignant nodules (37.5%), followed by the lower lobe of the left lung (18.6%). In comparison among different pathological types, the ages of CIS, MIA and IA were (54.1±10.9), (52.2±12.6) and (59.1±9.9) years (F=16.05, P＜0.01), the smoking rates were 10.3%, 3.7% and 21.4% (X2=24.31, P＜0.01), the median tumor diameter was 0.55, 0.60 and 0.80 cm (H=76.13, P＜0.01), respectively, with IA all being the highest, and the differences were statistically significant. The mutation frequency of exons 21 of epidermal growth factor receptor (EGFR), and tumor suppressor protein p53 (TP53) in IA were higher than those in CIS and MIA (P＜0.05), while the mutation frequency of human epidermal growth factor receptor 2 (HER2) exon 20ins, mitogen-activated protein kinase (MAP2K1) and serine/threonine protein kinase (BRAF) were lower than those in CIS and MIA, and the differences were statistically significant (P＜0.05). Conclusion: Patients with malignant pulmonary nodules may have the following characteristics: more common in women, non-smoking, located in the upper lobe of the right lung. There are differences in age, smoking rate, tumor diameter and driving gene mutation frequency among the three pathological types of malignant nodules.
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