Metastatic rate of lymph nodes in clinical stage Ⅰ non⁃small⁃cell lung cancer patients with mixed ground⁃glass opacity versus pure ground⁃glass opacity:Meta⁃analysis
Objective:This systematic review and Meta-analysis aimed to investigate the metastatic rate of hilar lymph node and mediastinal lymph node in clinical stage Ⅰ non-small-cell lung cancer patients with either pure ground-glass opacity(Pure-GGO)or mixed ground-glass opacity(Mixed-GGO),therefore to indicate how to dissect lymph nodes in patients with GGO. Methods:A systematic search of the published literature was conducted using the main databases(Science Direct,PubMed,Springer Link and Wiley Online Library)to collect relevant case-control studies that compared Pure-GGOs and Mixed-GGOs in clinical stage I non-small-cell lung cancer patients. Meta-analysis was performed extracting data from the published literature using STATA 12.0. The results of the Meta-analysis were expressed as an odds ratio(OR)and their corresponding 95% confidence interval(CI). Results:We extracted data from three case-control studies,with a total of 736 patients. There was no significant difference(OR=3.66,95% CI:0.68-19.58,P=0.13)in the rates of metastases in all lymph nodes in patients with either Pure-GGO or Mixed-GGO. In addition,there were no significant differences(OR=4.22,95% CI:0.77-23.19,P=0.10)in the rates of metastases in hilar lymph nodes in patients with either Pure-GGO or Mixed-GGO,but one study showed an OR of 20.18(95% CI:0.94-432.12). There was no significant difference in rates of metastases of mediastinal lymph nodes in patients with either Pure-GGO or Mixed-GGO(OR=1.10;95% CI:0.19-6.32,P=0.92). Conclusion:The results indicated no statistically significant difference in metastatic rates of hilar lymph nodes and mediastinal lymph nodes in patients with either Pure-GGO or Mixed-GGO. However,as thoracic surgeon,we must be particularly cautious about metastasis in hilar lymph nodes in patients with Mixed-GGO.