Imaging characteristics and surgical methods of pulmonary nodules located in external lung 1/3 group versus internal lung 2/3 group_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Dehao ^1,2 , LIAO Liangzhong ³ , LI Puchen ¹ , LIU Yue ¹ ,  CHEN Lichun ³

1. Department of Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, Fujian, P. R. China;
2. The Third Clinical Medical College, Fujian Medical University, Fuzhou, 350122, P. R. China;
3. Department of Radiology, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, 361003, Fujian, P. R. China;

Corresponding?author：

CHEN Lichun, Email: chenlichun12141990@163.com

Keywords：

CT-guided localization; pulmonary nodules; video-assisted thoracoscopic surgery; imaging characteristics; surgical method

DOI：

10.7507/1007-4848.202404007

Video：

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Objective To compare the imaging characteristics and surgical methods of pulmonary nodules in the external 1/3 group and internal 2/3 group. Methods A retrospective analysis of clinical data from patients who underwent thoracoscopic preoperative CT-guided lung nodule localization at the Department of Radiology, the First Affiliated Hospital of Xiamen University from September 2020 to April 2022 was conducted. Results A total of 215 patients were enrolled (247 pulmonary nodules), including 70 males and 145 females, with a median age of 48 years. Based on the location of the nodules under CT guidance, those located in the external 1/3 area of the lung were classified into an external 1/3 group, while those located in the middle 1/3 and inner 1/3 areas were classified into an internal 2/3 group. There was no statistical difference between the two groups in terms of general clinical data, nature of pulmonary nodules, distribution of pulmonary nodules in lobes, localization time, or localization complications (P>0.05). However, there were statistical differences in the distance of pulmonary nodules from the pleura [0.6 (0.0-1.9) cm vs. 1.8 (0.0-4.5) cm, P<0.001], size of pulmonary nodules [0.7 (0.2-1.8) cm vs. 1.0 (0.2-2.0) cm, P<0.001], and surgical methods (P=0.002). In the external 1/3 group, 92.1% of nodules underwent thoracoscopic wedge resection, while fewer patients underwent other procedures; in the internal 2/3 group, 77.1% of nodules underwent thoracoscopic wedge resection, and 19.3% underwent segmentectomy. Conclusion The diameter of pulmonary nodules, the distance of pulmonary nodules from the pleura, and surgical methods differ between the external 1/3 group and internal 2/3 group. Thoracic surgeons can develop more precise surgical plans based on the location and size of pulmonary nodules.

Citation： LIU Dehao, LIAO Liangzhong, LI Puchen, LIU Yue, CHEN Lichun. Imaging characteristics and surgical methods of pulmonary nodules located in external lung 1/3 group versus internal lung 2/3 group. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2025, 32(2): 180-184. doi: 10.7507/1007-4848.202404007 Copy

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	劉志敏, 祁佩紅. 低劑量與常規劑量CT在肺磨玻璃影結節鑒別和浸潤性診斷中的應用比較. 中國CT和MRI雜志, 2023, 21(11): 47-49.Liu ZM, Qi PH. Comparison of low-dose CT and conventional dose CT in the differentiation and invasive diagnosis of pulmonary ground glass nodules. Chin J CT MRI, 2023, 21(11): 47-49.
3.	孫蓮, 馬紅萍, 吳文英. 肺結節診斷及手術治療的研究進展. 標記免疫分析與臨床, 2023, 30(8): 1431-1434, 1440.Sun L, Ma HP, Wu WY. The research progress in the diagnosis and surgical treatment of pulmonary nodules. Label Immunoass Clin Med, 2023, 30(8): 1431-1434, 1440.
4.	肺小結節術前輔助定位技術專家共識(2019版)專家組. 肺小結節術前輔助定位技術專家共識(2019版). 中國胸心血管外科臨床雜志, 2019, 26(2): 109-113.Writing Committee of Expert Consensus on Preoperative Auxiliary Localization Techniques for Pulmonary Nodules. Expert consensus on preoperative auxiliary localization techniques for pulmonary nodules. Chin J Clin Thorac Cardiovasc Surg, 2019, 26(2): 109-113.
5.	Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, version 3. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(5): 497-530.
6.	張華, 郭堅溪, 孔健. 肺小結節胸腔鏡切除術前定位方法的應用進展. 介入放射學雜志, 2022, 31(12): 1216-1221.Zhang H, Guo JX, Kong J. Advances in the application of preoperative localization methods in thoracoscopic resection of small pulmonary nodules. J Interv Radiol, 2022, 31(12): 1216-1221.
7.	劉寶東, 陳海泉, 劉倫旭, 等. 肺結節多學科微創診療中國專家共識. 中國胸心血管外科臨床雜志, 2023, 30(8): 1061-1074.Liu BD, Chen HQ, Liu LX. Chinese experts consensus on multidisciplinary minimally invasive diagnosis and treatment of pulmonary nodules. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(8): 1061-1074.
8.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
9.	李波. 胸腔鏡下解剖性肺段切除術與肺楔形切除術治療Ⅰ期NSCLC的臨床效果對比. 中國實用醫藥, 2023, 18(12): 5-8.Li B. Comparison of the clinical effect of thoracoscopic anatomical segmentectomy and pulmonary wedge resection in the treatment of stageⅠNSCLC. China Pract Med, 2023, 18(12): 5-8.
10.	陳國標, 周建平, 杜巍, 等. 胸腔鏡肺楔形切除術、胸腔鏡下肺段切除術、胸腔鏡肺葉切除術治療早期肺癌的療效比較研究. 實用心腦肺血管病雜志, 2022, 30(4): 23-28.Chen GB, Zhou JP, Du W, et al. Comparative study on the curative effect of thoracoscopic lung wedge resection, thoracoscopic segmentectomy and thoracoscopic lobectomy in the treatment of early stage lung cancer. Pract J Card Cereb Pneum Vasc Dis, 2022, 30(4): 23-28.
11.	Liu D, Zhang R, Yu X, et al. Comparison of two methods for CT-guided pulmonary nodule location before thoracoscopic surgery. Wideochir Inne Tech Maloinwazyjne, 2023, 18(4): 680-689.
12.	Dias M, Linhas R, Campainha S, et al. Lung cancer in never-smokers: What are the differences? Acta Oncol, 2017, 56(7): 931-935.
13.	Dubin S, Griffin D. Lung cancer in non-smokers. Mo Med, 2020, 117(4): 375-379 .
14.	Mederos N, Friedlaender A, Peters S, et al. Gender-specific aspects of epidemiology, molecular genetics and outcome: Lung cancer. ESMO Open, 2020, 5(Suppl 4): e000796.
15.	梁敏, 吳寧. 女性肺癌的危險因素和篩查現狀. 國際醫學放射學雜志, 2022, 45(5): 539-544.Liang M, Wu N. Risk factors and screening of lung cancer in women. Int J Med Radiol, 2022, 45(5): 539-544.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 劉志敏, 祁佩紅. 低劑量與常規劑量CT在肺磨玻璃影結節鑒別和浸潤性診斷中的應用比較. 中國CT和MRI雜志, 2023, 21(11): 47-49.Liu ZM, Qi PH. Comparison of low-dose CT and conventional dose CT in the differentiation and invasive diagnosis of pulmonary ground glass nodules. Chin J CT MRI, 2023, 21(11): 47-49.
3. 孫蓮, 馬紅萍, 吳文英. 肺結節診斷及手術治療的研究進展. 標記免疫分析與臨床, 2023, 30(8): 1431-1434, 1440.Sun L, Ma HP, Wu WY. The research progress in the diagnosis and surgical treatment of pulmonary nodules. Label Immunoass Clin Med, 2023, 30(8): 1431-1434, 1440.
4. 肺小結節術前輔助定位技術專家共識(2019版)專家組. 肺小結節術前輔助定位技術專家共識(2019版). 中國胸心血管外科臨床雜志, 2019, 26(2): 109-113.Writing Committee of Expert Consensus on Preoperative Auxiliary Localization Techniques for Pulmonary Nodules. Expert consensus on preoperative auxiliary localization techniques for pulmonary nodules. Chin J Clin Thorac Cardiovasc Surg, 2019, 26(2): 109-113.
5. Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, version 3. 2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(5): 497-530.
6. 張華, 郭堅溪, 孔健. 肺小結節胸腔鏡切除術前定位方法的應用進展. 介入放射學雜志, 2022, 31(12): 1216-1221.Zhang H, Guo JX, Kong J. Advances in the application of preoperative localization methods in thoracoscopic resection of small pulmonary nodules. J Interv Radiol, 2022, 31(12): 1216-1221.
7. 劉寶東, 陳海泉, 劉倫旭, 等. 肺結節多學科微創診療中國專家共識. 中國胸心血管外科臨床雜志, 2023, 30(8): 1061-1074.Liu BD, Chen HQ, Liu LX. Chinese experts consensus on multidisciplinary minimally invasive diagnosis and treatment of pulmonary nodules. Chin J Clin Thorac Cardiovasc Surg, 2023, 30(8): 1061-1074.
8. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
9. 李波. 胸腔鏡下解剖性肺段切除術與肺楔形切除術治療Ⅰ期NSCLC的臨床效果對比. 中國實用醫藥, 2023, 18(12): 5-8.Li B. Comparison of the clinical effect of thoracoscopic anatomical segmentectomy and pulmonary wedge resection in the treatment of stageⅠNSCLC. China Pract Med, 2023, 18(12): 5-8.
10. 陳國標, 周建平, 杜巍, 等. 胸腔鏡肺楔形切除術、胸腔鏡下肺段切除術、胸腔鏡肺葉切除術治療早期肺癌的療效比較研究. 實用心腦肺血管病雜志, 2022, 30(4): 23-28.Chen GB, Zhou JP, Du W, et al. Comparative study on the curative effect of thoracoscopic lung wedge resection, thoracoscopic segmentectomy and thoracoscopic lobectomy in the treatment of early stage lung cancer. Pract J Card Cereb Pneum Vasc Dis, 2022, 30(4): 23-28.
11. Liu D, Zhang R, Yu X, et al. Comparison of two methods for CT-guided pulmonary nodule location before thoracoscopic surgery. Wideochir Inne Tech Maloinwazyjne, 2023, 18(4): 680-689.
12. Dias M, Linhas R, Campainha S, et al. Lung cancer in never-smokers: What are the differences? Acta Oncol, 2017, 56(7): 931-935.
13. Dubin S, Griffin D. Lung cancer in non-smokers. Mo Med, 2020, 117(4): 375-379 .
14. Mederos N, Friedlaender A, Peters S, et al. Gender-specific aspects of epidemiology, molecular genetics and outcome: Lung cancer. ESMO Open, 2020, 5(Suppl 4): e000796.
15. 梁敏, 吳寧. 女性肺癌的危險因素和篩查現狀. 國際醫學放射學雜志, 2022, 45(5): 539-544.Liang M, Wu N. Risk factors and screening of lung cancer in women. Int J Med Radiol, 2022, 45(5): 539-544.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Imaging characteristics and surgical methods of pulmonary nodules located in external lung 1/3 group versus internal lung 2/3 group

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