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CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter

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Abstract

Objective

To evaluate CT and histopathologic features of lung adenocarcinoma with pure ground-glass nodule (pGGN) ≤10 mm in diameter.

Methods

CT appearances of 148 patients (150 lesions) who underwent curative resection of lung adenocarcinoma with pGGN ≤10 mm (25 atypical adenomatous hyperplasias, 42 adenocarcinoma in situs, 38 minimally invasive adenocarcinomas, and 45 invasive pulmonary adenocarcinomas) were analyzed for lesion size, density, bubble-like sign, air bronchogram, vessel changes, margin, and tumour-lung interface. CT characteristics were compared among different histopathologic subtypes. Univariate and multivariate analysis were used to assess the relationship between CT characteristics of pGGN and lesion invasiveness, respectively.

Results

There were statistically significant differences among histopathologic subtypes in lesion size, vessel changes, and tumour-lung interface (P<0.05). Univariate analysis revealed significant differences of vessel changes, margin and tumour-lung interface between preinvasive and invasive lesions (P<0.05). Logistic regression analysis showed that the vessel changes, unsmooth margin and clear tumour-lung interface were significant predictive factors for lesion invasiveness, with odds ratios (95% CI) of 2.57 (1.17-5.62), 1.83 (1.25-2.68) and 4.25 (1.78-10.14), respectively.

Conclusion

Invasive lesions are found in 55.3% of subcentimeter pGGNs in our cohort. Vessel changes, unsmooth margin, and clear lung-tumour interface may indicate the invasiveness of lung adenocarcinoma with subcentimeter pGGN.

Key points

• Invasive lesions were found in 55.3% of lung adenocarcinomas with subcentimeter pGGNs

• Lesion size, vessel changes, and tumour-lung interface showed different among histopathologic subtypes

• Vessel changes, unsmooth margin and clear tumour-lung interface were predictors for lesion invasiveness

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Abbreviations

CT:

Computed tomography

pGGN:

Pure ground-glass nodule

AAH:

Atypical adenomatous hyperplasia

AIS:

Adenocarcinoma in situ

MIA:

Minimally invasive adenocarcinoma

IPA:

Invasive pulmonary adenocarcinoma

HU:

Hounsfield unit

ANOVA:

One-way analysis of variance

SNK:

Student-Newman-Keuls

IASLC:

International Association for the Study of Lung Cancer

ATS:

American Thoracic Society

ERS:

European Respiratory Society

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Author notes

    Authors and Affiliations

    1. Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China

      Fang Wu, Xin Jin, Rui Jing, Yue-qing Yang, Mei Jin & Shao-hong Zhao

    2. Department of Radiology, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, 100053, China

      Fang Wu

    3. Department of Radiology, Navy General Hospital, 28 Fucheng Road, Beijing, 100048, China

      Shu-ping Tian

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    1. Fang Wu
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    2. Shu-ping Tian
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    3. Xin Jin
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    Correspondence to Shao-hong Zhao.

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    The scientific guarantor of this publication is Dr. Shaohong Zhao.

    Conflict of interest

    The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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    The authors state that this work has not received any funding.

    Statistics and biometry

    No complex statistical methods were necessary for this paper.

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    Institutional Review Board approval was required.

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    Written informed consent was required for this study.

    Methodology

    • retrospective

    • diagnostic or prognostic study

    • performed at one institution

    Additional information

    Fang Wu and Shu-ping Tian contributed equally to this work.

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    Wu, F., Tian, Sp., Jin, X. et al. CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter. Eur Radiol 27, 4037–4043 (2017). https://doi.org/10.1007/s00330-017-4829-5

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    • DOI: https://doi.org/10.1007/s00330-017-4829-5

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