Characteristics And Natural History Analysis Of Pulmonary Ground-Glass Nodules In Hospital Employees And Their Parents

Introduction:With the popularization of lung cancer screening,the detection rate of pulmonary ground-glass nodules(GGNs)is increasing,and some GGNs are imaging manifestations of lung cancer.The clinical management of GGNs is of great importance.The pathogenesis of GGNs is unclear.Studying the characteristics and natural history of GGNs in parents and children is helpful to understand the role of genetic factors in the occurrence and development of ground-glass nodule(GGN),and can assist us in the judgment of benign and malignant GGN,and optimize the management process of GGN.Methods:Among employees and parents who underwent low-dose computed tomography(LDCT)lung cancer screening in Xiangya Hospital of Central South University,392 employees with GGN and 254 parents with GGN were collected.three cohorts were created from them:Cohort 1employees with GGN,and their parents without GGN;Cohort 2employees with GGN,and at least one parent with GGN;Cohort 3employees without GGN,and at least one parent with GGN.Compare the clinical characteristics,imaging and pathological characteristics of GGN between employees and parents,and establish follow-up cohorts of the natural history in paired employees and parents.we analyzed the clinical-imaging-pathological characteristics and natural history differences of different cohorts,and then use logistic regression analysis to screen for risk factors related to GGN growth.Results:The detection rate of GGNs among employees was higher than that of parents(P<0.001).Parents had more GGNs that were≥10 mm(P<0.001),LU-RADS 4 class(P<0.001),LU-RADS 4B class(P=0.003),LU-RADS 4C class and 5 class(P=0.001)than enployees.There were 36 groups(27.1%)that both employees and their parent had GGN in the GGN follow-up cohort.Parents in cohort 2 had larger GGN(P=0.042),and more LU-RADS 4-5 class GGN(P=0.015)than parents in cohort 3.In cohort 2,parents had more GGNs≥10 mm than employees(P=0.001),and GGNs of parents had higher LU-RADS class(P=0.001).Thirty-eight employees and parents underwent surgical resection,and postoperative pathologies were confirmed invasive adenocarcinoma,minimally invasive adenocarcinoma or precursor glandular lesions.The proportion of parents with the natural history of "increase" was more than that of employees(P=0.008),while the proportion of parents with the natural history of "shrinking or absorption" was less than that of employees(P=0.048).Among employees,male gender(P=0.001)and family history of lung cancer(P=0.016)were associated with GGN "increase";among parents,nodule diameter≥10 mm(P=0.013)was associated with GGN "increase".Conclusion:In the groups of employees and parent with pulmonary ground glass nodules,1/4 of them both had GGN.Although the detection rate of GGN in parents was lower than that in employees,the class of nodules was significantly higher in parents.Parents and employees had different GGN natural history change trends and risk factors for growth.