What should I do if I find ground glass nodules? These two things are very important

On April 28, 2021, the 77th patient education live broadcast of TopMD's brand patient education program in the field of oncology, "Let's Meet the Great Doctor", discussed the new research on lung cancer, which is closely related to you and me.

This live broadcast is a special "Dialogue with Lung Cancer Experts" planned by TopMD's "Let's Meet the Doctor" for the 2021 National Cancer Prevention and Control Week. The expert who was the guest in the "Let's Meet the Doctor" live broadcast room is: Professor Chen Haiquan, a famous thoracic surgery expert, director of the Institute of Thoracic Tumors at Fudan University, and director of the Department of Thoracic Surgery at the Affiliated Cancer Hospital of Fudan University. The live broadcast was broadcast simultaneously on the homepage of 9 platforms in the TopMD all-media matrix: Sohu Health, Sohu Video, Sina News, Tencent News, Healthy China TV, Tencent Video, Toutiao, Xigua Video, and Baidu Health, with an online viewing volume of up to 1,330,338 times.

For the convenience of patients, we edited the essence of this live broadcast into an anti-cancer public course and broadcast it twice on the entire network. Today, let’s talk about episode (3): Although many health science programs also emphasize that you should not panic when you find lung nodules, let alone ground glass nodules, and there is no need to always check low-dose CT, there are still many friends who are overly worried and frequently check CT. It is even common to see patients doing CT three times a week in the outpatient clinic. This is not only a waste of medical resources, but also frequent CT examinations in a short period of time will cause irreversible radiation dose accumulation damage to the body.

So how should we treat ground glass nodules scientifically? Professor Chen Haiquan gave us the following advice.

1. After the thin-layer CT scan, ask the imaging department to copy the video first, because the current screening is done through CT, which is a thin-layer scan. One examination will scan hundreds of images, and each image actually contains information. If you do not request a copy, you may only be given a few dozen films each time. This is like a book with 500 pages, 50 pages are torn off from the middle and these 50 pages are shown to the doctor. However, if you ask the doctor what details are on the other 450 pages, the doctor has not seen them and does not know, so the doctor cannot make a hasty conclusion about your condition.

Therefore, examining ground glass nodules requires relatively high standards. It is different from the examinations in the past film era. Film can only show solid masses of 2cm-3cm. When examining ground glass nodules, that kind of film does not magnify the suspicious areas, so it is difficult to see the details and is not enough to identify the problem. Therefore, it is very important to copy the imaging data after the CT scan. You cannot just go to the outpatient clinic to see a doctor with a few films, otherwise you will not be able to see clearly!

2. I will teach you a method of identification, which is more than 90% correct. If you have a ground-glass nodule and there is no change in the follow-up within half a year, then there is about a 90% chance that it is malignant. But even if it is malignant, if it is a pure ground-glass nodule, we can still wait and see, because the surgical treatment window for this type of nodule is particularly wide, and you can choose a suitable time to treat it, because it is in the early stage and there will be no distant metastasis and lymph node metastasis, which means that the effect of surgery now is the same as that of surgery a few years later.

Especially for small, pure ground glass nodules of a few millimeters, let me tell you a number. If it is a pure ground glass nodule <10mm, the chance of it growing within 5 years is only 11%, which means that most of them will not grow, and even if they grow, they will grow very slowly. If it is >10mm, you should be careful, about 50% will grow within 5 years. If it is a mixed ground glass nodule <10mm, about 1/3 will grow within 5 years, and if it is >10mm, about 90% will grow.

So you must look at the size and see if the ground glass nodules are pure or mixed. Some ground glass nodules are caused by inflammation, some are caused by bleeding, and some are caused by other infections, so they are not all tumors. Give it a certain amount of observation time. If it is inflammation, it will definitely change during this period of observation. Most ground glass nodules are inflammation. Those that disappear or significantly increase in size within 1-2 months are almost all inflammation.

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