Value analysis of CT features of focal ground-glass pulmonary nodules in the diagnosis of lung adenocarcinoma at different stages / 中国医师杂志

ABSTRACT

Objective:To investigate the value of computed tomography (CT) in the diagnosis of lung adenocarcinoma in different stages of focal ground-glass nodules (GGN).Methods:153 cases of lung adenocarcinoma with focal ground-glass nodule confirmed by surgery and pathology in Xiangya Hospital of Central South University from 2017 to 2020 were retrospectively analyzed. The location, size, shape, boundary, density, blood vessels and bronchus of the lesions were analyzed by statistical analysis to determine the correlation between CT features and lung adenocarcinoma in different periods.Results:153 focal ground-glass nodules showed pure ground-glass nodules (pGGN) in 21 cases, mixed ground-glass nodules (mGGN) in 132 cases. 32 cases of pre-invasive lesions in lung adenocarcinoma at different stages, including 13 cases of type adenomatous hyperplasia (AAH), 19 cases of carcinoma in situ (AIS); 121 cases of invasive disease, including 35 cases of microinvasive adenocarcinoma (MIA) and 86 cases of invasive adenocarcinoma (IA); There were statistically significant differences in the CT image features of four different stages of pulmonary ground-glass nodule adenocarcinoma patients in the edge lobulation, thick and short burr, bronchial passage and occlusion, vascular thickening and convergence ( P<0.05). There were no statistically significant difference in the clear boundary, shape, slender burr, mild bronchiectasis, irregular vascular passing signs among the groups ( P>0.05). There were significant differences in the maximum length diameter and CT value of ground-glass nodules before infiltration and infiltrating lesions in 153 cases ( P<0.05). Receiver operating characteristic (ROC) curve analysis found that the combined evaluation of the maximum layer length and CT value of lesions had a good value for the invasion of lung adenocarcinoma, and the cut-off points were 13.04 mm, -447.48 Hu, respectively. There were significant differences in the maximum layer length and CT value between pGGN and mGGN ( P<0.05). Conclusions:Through the analysis of CT findings of lung adenocarcinoma in different stages of focal ground-glass nodule, it was found that different signs had different value for the pathological types of lung adenocarcinoma in different stages. mGGN was more inclined to invasive lesions, and GGN appeared lobulation, thick and short burr, vascular convergence, bronchial occlusion, and when the lesion diameter was more than 13.04 mm, average CT value >-447.48 Hu, highly suggestive of invasive lung adenocarcinoma.