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CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity

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Abstract

Objectives

To analyze the CT characteristics and pathological classification of early lung adenocarcinoma (T1N0M0) with pure ground-glass opacity (pGGO).

Methods

Ninety-four lesions with pGGO on CT in 88 patients with T1N0M0 lung adenocarcinoma were selected from January 2010 to December 2012. All lesions were confirmed by pathology. CT appearances were analyzed including lesion location, size, density, uniformity, shape, margin, tumour-lung interface, internal and surrounding malignant signs. Lesion size and density were compared using analysis of variance, lesion size also assessed using ROC curves. Gender of patients, lesion location and CT appearances were compared using χ2-test.

Results

There were no significant differences in gender, lesion location and density with histological invasiveness (P > 0.05). The ROC curve showed that the possibility of invasive lesion was 88.73 % when diameter of lesion was more than 10.5 mm. There was a significant difference between lesion uniformity and histological invasiveness (P = 0.01). There were significant differences in margin, tumour-lung interface, air bronchogram with histological invasiveness ( P = 0.02,P = 0.00,P = 0.048). The correlation index of lesion size and uniformity was r = 0.45 (P = 0.00).

Conclusions

The lesion size and uniformity, tumour-lung interface and the air bronchogram can help predict invasive extent of early stage lung adenocarcinoma with pGGO.

Key Points

• CT characteristics and pathological classification of pGGO lung adenocarcinoma smaller than 3 cm

• The optimal cut-off value for discriminating preinvasive from invasive lesions was 10.5 mm

• Uniformity was significant difference between histological subtypes and correlated with lesion size

• Tumour margin, tumour-lung interface and air bronchogram showed different between histological types

• No significant difference in gender, lesion location and density with histological subtypes

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Abbreviations

pGGO:

pure ground-glass opacity

AAH:

atypical adenomatous hyperplasia

AIS:

adenocarcinoma in situ

MIA:

invasive adenocarcinoma

BAC:

bronchioloalveolar adenocarcinoma

ANOVA:

one-way analysis of variance

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Acknowledgments

We would like to express special thanks to the doctors at the radiology department of PLA general hospital. The scientific guarantor of this publication is Zhao Shaohong. 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. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because this is a retrospective study. Written informed consent was not required for this study because this is a retrospective study. Approval from the institutional animal care committee was not required because this study is not on animals. Some study subjects or cohorts have not been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

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

    Xin Jin, Shao-hong Zhao, Jian Wu, Chong-chong Wu, Rui-ping Chang & Hai-yue Ju

  2. Department of Pathology, Chinese PLA General Hospital, Beijing, 100853, China

    Jie Gao & Dian-jun Wang

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  1. Xin Jin
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  2. Shao-hong Zhao
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  3. Jie Gao
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  4. Dian-jun Wang
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  5. Jian Wu
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Correspondence to Shao-hong Zhao.

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Jin, X., Zhao, Sh., Gao, J. et al. CT characteristics and pathological implications of early stage (T1N0M0) lung adenocarcinoma with pure ground-glass opacity. Eur Radiol 25, 2532–2540 (2015). https://doi.org/10.1007/s00330-015-3637-z

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  • DOI: https://doi.org/10.1007/s00330-015-3637-z

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