Systematic explanation about micro-invasive adenocarcinoma (MIA) of the lungs

Lung carcinoma in situ (AIS) grows slowly and may stay the same for life

Carcinoma in situ further develops and it will become micro-invasive adenocarcinoma (MIA), so is it necessary to operate immediately for micro-invasive carcinoma? What is the appropriate time to deal with it? In order to clarify this issue, here is a summary of the contents of microinvasive adenocarcinoma

1.

1.

The black arrow points to the infiltration area.

 

In addition to the ratio, the pathological diagnosis of microinvasive adenocarcinoma also needs to meet the following conditions: no more than 3 cm, no invasion of blood vessels, no invasion of lymphatic vessels, no invasion of the pleura, no tumor necrosis, no interalveolar metastasis (STAS)

In addition, the infiltrating component of micro-invasive adenocarcinoma can be any pathological type of adenocarcinoma (acini, papilla, micropapilla, solid, intestinal type, fetal type or aggressive mucinous adenocarcinoma)

In addition, the infiltrating component of micro-invasive adenocarcinoma can be any pathological type of adenocarcinoma (acini, papilla, micropapilla, solid, intestinal type, fetal type or aggressive mucinous adenocarcinoma)

2.

In general, the morphology of the lung nodules of micro-invasive adenocarcinoma on CT is mostly less than 10mm, which can be pure ground glass nodules or mixed ground glass nodules (solid components not exceeding 5mm)

The pulmonary nodules of micro-invasive adenocarcinoma are mostly less than 10mm in shape, which can be pure ground glass nodules or mixed ground glass nodules (the solid component does not exceed 5mm)

These nodules are very typical, with clear borders and abnormal blood vessels, which do not disappear after one follow-up

The morphological differences between MIA and AIS for carcinoma in situ are as follows: If the CT value of pure ground glass nodules is higher than -500, there may be microinvasion

It is recommended to use the 1mm layer thickness image of the CT soft tissue algorithm to measure the highest CT value of ground glass nodules, avoiding blood vessels as much as possible

It is recommended to use the 1mm layer thickness image of the CT soft tissue algorithm to measure the highest CT value of ground glass nodules, avoiding blood vessels as much as possible

3.

3.
Will microinvasive adenocarcinoma recur after surgery?

This is a general concern
.
According to a number of retrospective studies, there have been no cases of microinvasive adenocarcinoma after 5 years of recurrence
.

For example, according to statistics from Shanghai Chest Hospital, the recurrence rate of 675 cases of MIA after 5 years is 0, which is exactly the same as that of carcinoma in situ
.
Therefore, the prognosis of MIA, like carcinoma in situ, is a complete cure
.
MIA has a survival period of less than 5 years, but it has nothing to do with lung cancer
.

Therefore, the possibility of recurrence of micro-invasive adenocarcinoma after surgery only exists in theory, and no recurrence of micro-invasive adenocarcinoma has been seen clinically
.

Therefore, the possibility of recurrence of micro-invasive adenocarcinoma after surgery only exists in theory, and no recurrence of micro-invasive adenocarcinoma has been seen clinically
.

4.
Which CT shows micro-invasive adenocarcinoma may have a very small amount of risk?

4.
Which CT shows micro-invasive adenocarcinoma may have a very small amount of risk?

Since the microinvasive adenocarcinoma has not recurred after surgery, continue to observe these nodules.
Is it absolutely safe if they are enlarged and then operated on?

Although there are no cases of recurrence of microinvasive adenocarcinoma after surgery, some microinvasive adenocarcinomas that may affect it can be treated early
.

That is, micro-invasive adenocarcinoma with solid components and micro-invasive adenocarcinoma close to the pleura
.

 

In this study, nodules with ground glass components, whether AIS/MIA, or even invasive adenocarcinoma, did not have any recurrence in statistics within 10 years after surgery
.

As long as the mixed ground glass nodules are dominated by solid components, there is a risk of recurrence
.

Therefore, the risk of recurrence of pulmonary nodules after surgery all comes from the solid component of the nodule.
The more solid components, the higher the probability of recurrence of the nodule
.

For micro-invasive adenocarcinoma, the presence of solid components means that there is a theoretical risk of recurrence
.

For micro-invasive adenocarcinoma, the presence of solid components means that there is a theoretical risk of recurrence
.

Another study reviewed the danger of pleural invasion
.
For ground-glass lung nodules, pleural connection is a factor that may affect survival, and the 5-year survival period is 97.
25%
.
Not 100% anymore
.

Therefore, we say that the very small risk of microinvasive adenocarcinoma comes from whether it has solid components and whether it is attached to the pleura
.

Therefore, we say that the very small risk of microinvasive adenocarcinoma comes from whether it has solid components and whether it is attached to the pleura
.

5.
Treatment options for micro-invasive adenocarcinoma

5.
Treatment options for micro-invasive adenocarcinoma

Early resection can be considered for micro-invasive adenocarcinoma with solid components and attached to the pleura
.
For micro-invasive adenocarcinoma with pure ground glass nodules, observation is safe
.

For example, this mixed ground glass nodule mainly composed of ground glass, the solid component does not exceed 5 mm, CT judged to be micro-invasive adenocarcinoma
.
However, there are solid components, and there may be unfavorable pathological types
.
Resection is recommended .

This is also a ground-glass nodule.
Because some ground-glass components have a higher density, it is also a micro-invasive adenocarcinoma, but it has no solid components and does not stick to the pleura.
You can continue to observe
.

Tips of this issue

Tips of this issue

1.
It can be judged from the preoperative CT whether the nodule has reached the stage of micro-invasive adenocarcinoma
.

1.
It can be judged from the preoperative CT whether the nodule has reached the stage of micro-invasive adenocarcinoma
.

2.
There was no recurrence of micro-invasive adenocarcinoma after surgery
.

2.
There was no recurrence of micro-invasive adenocarcinoma after surgery
.

3.
Micro-invasive adenocarcinoma with pure ground glass nodules can be observed
.

3.
Micro-invasive adenocarcinoma with pure ground glass nodules can be observed
.

4.
Micro-invasive adenocarcinoma with solid components and ground-glass nodules attached to the pleura may be considered for early resection
.

4.
Micro-invasive adenocarcinoma with solid components and ground-glass nodules attached to the pleura may be considered for early resection
.

Source: Frontier of Lung Nodules

Source: The front of lung nodules

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