Clinical characteristics of ground-glass opacities in young patients : a single-center retrospective study

Pulmonary ground-glass opacities (GGOs) are increasingly being detected through screening in younger patients, this study aimed to characterize the features of young patients with GGOs. Patients aged ≤ 55 years who underwent surgical treatment for GGOs at Tongji Hospital of Wuhan from August 2018 to July 2021 were retrospectively analyzed. Clinical and pathological data were collected and compared between age groups. Among 1,283 patients, 70.1% were female and 87.0% were nonsmokers. Patients were divided into a young group (18–45 years) and a middle-aged group (46–55 years). Compared with the middle-aged group, young patients had a higher proportion of incidental cases detected during health check-ups (74.6% vs. 66.7%), fewer underlying diseases (2.7% vs. 15.3%), and a lower prevalence of family history of tumors (17.9% vs. 27.6%). Their GGOs were smaller (median 9 mm vs. 10 mm) and more often pure (77.2% vs. 67.0%), with higher rates of adenomatous hyperplasia (4.2% vs. 3.2%), adenocarcinoma in situ (24.3% vs. 19.8%), and minimally invasive adenocarcinoma (34.5% vs. 28.0%). A greater proportion of stage 0 and stage IA1 lesions was also observed (83.0% vs. 70.7%). Wedge resection and segmentectomy were performed more frequently in the young group, whereas lobectomy was less common. The EGFR mutation rate was also lower (47.5% vs. 75.5%). An increasing number of patients under the age of 46 with GGO have been diagnosed with early-stage lung cancer during their medical examinations, but most of them do not have risk factors. Young patients exhibit distinct imaging, pathological, surgical, and genetic characteristics, underscoring the need for further large-scale studies. TJ-IRB20221294.