{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:52:37Z","timestamp":1785775957524,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515012469"],"award-info":[{"award-number":["2022A1515012469"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The clinical characteristics and pathophysiological processes of super\u2010multiple ground\u2010glass nodules (GGNs) remain poorly understood due to their rare incidence. This retrospective\u2010prospective study aimed to elucidate these aspects by analyzing 75 patients with \u201csuper\u2010multiple GGNs,\u201d having more than five persistent nodules, each measuring at least 5\u2009mm, identified from a larger cohort of 2589 patients. We compared these patients with those having solitary GGNs (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009691) and 2\u20135 GGNs (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u2009458) to evaluate clinical and radiological characteristics. All patients underwent a minimum 12\u2010month follow\u2010up with detailed documentation of nodule changes and treatments. Patients with super\u2010multiple GGNs were significantly older, predominantly female, had lower smoking rates, and showed higher smog exposure and cough prevalence than other patients (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.05). Radiologically, super\u2010multiple GGNs appeared mostly unilaterally, predominantly in the right lung and upper lobes (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001). Progression occurred in 33.3% of these patients, of whom 44.0% exhibited simultaneous growth of multiple nodules. Compared with solitary GGNs (HR\u2009=\u20096.64, 95% CI\u2009=\u20093.18\u201313.84,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001) and 2\u20135 GGNs (HR\u2009=\u20093.26, 95% CI\u2009=\u20091.67\u20136.31,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u2009.001), super\u2010multiple GGNs carried significantly higher progression risk. These findings highlight the distinct clinical characteristics and radiological evolutionary patterns of super\u2010multiple GGNs, suggesting possible links to pulmonary inflammation.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70066","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T10:35:56Z","timestamp":1756722956000},"page":"60-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinctive clinical and radiological characteristics of persistent super\u2010multiple ground\u2010glass pulmonary nodules"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3726-5948","authenticated-orcid":false,"given":"Junhan","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University  Guangzhou China"},{"name":"Shantou 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