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e20505 Background: Lung ground-glass opacity (GGO), a hazy increased opacity on computed tomography with preservation of bronchial and vascular margins, has been shown to be associated with early-stage lung cancer. With the increasing prevalence of ground-glass opacity-type lung cancer (GGO-LC), more researches have focused on the diagnosis and treatment of this early stage lung cancer; however, the clinical characteristics and survival outcomes of this disease has not yet been fully elucidated. Aim: To analyze and review the clinicopathological characteristics for GGO-LC and to identify the optimal treatment strategies in this select population. A systematic review and meta-analysis of the literature were carried out. The study was registered (CRD42021228774). Methods: We did a systematic review and meta-analysis of observational studies published from database inception to June 30, 2020, which reported on clinicopathological characteristics, management and survival outcomes in patients with GGO-LC. Studies were identified by searches in PubMed, MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and by hand searching of previous publications. We extracted the general information to perform the meta-analysis, mainly focusing on age, gender, and smoking status. We also extracted treatment and prognosis information to assess the effect of treatment strategies on overall survival (OS). Robustness of pooled estimates from random-effects models was considered with sensitivity analyses, meta-regression, and subgroup analyses. All statistical analyses were performed with Stata 16.0. Results: Data on 9444 patients in 27 observational studies were included. GGO-type lung cancer was typically characterized as non-invasively or minimally invasively low-grade adenocarcinomas. Therapeutic intervention for these early stage lung cancers was an important opportunity for decreasing overall mortality of lung cancer. The final pooled analysis showed that the average age at diagnosis, female proportion and non-smoking proportion of patients with GGO-LC was 57.7 (95% CI, 53.9-61.5, P < 0.001, I2 = 92.9%), 0.591 (95% CI, 0.563-0.619, P < 0.001, I2 = 86.7%), and 0.631 (95% CI, 0.556-0.706, P < 0.001, I2 = 98.3%), respectively. The pooled overall survival rate was 96.2% (95% CI, 0.954 to 0.970, P < 0.001, I2 = 78.9%). The results showed that the majority of GGO-LC patients had good survival outcomes, presenting a significant proportion of young, female and non-or light smokers. Conclusions: From our analysis, it demonstrates that the patients with GGO-LC may be relatively young females and non-or light smoking history, and had better prognosis. However, there are some limitations in the present study, and more evidence is necessary to wait for more results from RCT to draw a valid conclusion.

Spontaneous colonic perforation in adults (SCPA) is rare but important. Its clinicopathological features and outcomes remain unclear. Therefore, the aim of the current study was to explore and investigate the clinicopathological characteristics, clinical outcomes and potential risk factors for patients with SCPA. Data of seven patients with SCPA treated in our hospitals from January 2008 to December 2017, and 221 cases from research databases before 2018 were retrospectively analyzed. The description of SCPA included stercoral perforation of the colon (SPC), idiopathic perforation of the colon (IPC) and spontaneous colonic perforation (SCP) in the study. All SCPA patients presented with unexplained abdominal pain and peritonitis. The median age was 62.5 years. The definite diagnosis preoperatively was 20.6%. The commonest lesion location was sigmoid colon and Hartmann’s operation accounted for 59.3%. Histopathology of stercoral perforation (HSP) and histopathology of idiopathic perforation (HIP) were two histopathological findings. Postoperative complication was 67.7% and mortality was 31.1%. Univariate and multivariate analyses showed that chronic constipation was an independent risk factor for histopathological features ( p ≤ 0.001, p = 0.005). Age of patients was associated with both postoperative complication ( p = 0.012, p = 0.044) and mortality ( p = 0.013, p = 0.034). Univariate analysis showed that HSP was associated with postoperative complication ( p = 0.015). Our findings from the analysis pertaining to SCPA confirm those from previous studies, supporting the SCPA, as a uniform description, is an infrequent and life-threatening disease requiring early surgical intervention. We found that the elderly with chronic constipation was a high-risk category and those with HIP had a more favorable outcome than that of patients with HSP.