CT and histopathologic characteristics of lung adenocarcinoma with pure ground-glass nodules 10 mm or less in diameter
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To evaluate CT and histopathologic features of lung adenocarcinoma with pure ground-glass nodule (pGGN) ≤10 mm in diameter.
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.
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.
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.
• 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
KeywordsGround-glass nodule Lung neoplasms Adenocarcinoma Histopathology Tomography, X-ray computed
Pure ground-glass nodule
Atypical adenomatous hyperplasia
Adenocarcinoma in situ
Minimally invasive adenocarcinoma
Invasive pulmonary adenocarcinoma
One-way analysis of variance
International Association for the Study of Lung Cancer
American Thoracic Society
European Respiratory Society
Compliance with ethical standards
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.
The authors state that this work has not received any funding.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Institutional Review Board approval was required.
Written informed consent was required for this study.
• diagnostic or prognostic study
• performed at one institution
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