| BACKGROUND&OBJECTIVE:The incidence rate of primary lung adenocarcinoma has been increasing recently.Its cause is multifactorial and there is no consensus at present.However,with the upgrading of medical inspection in various hospitals,especially the application of high-resolution CT,a large number of early adenocarcinoma were diagnosed,in which the growth of female patients is particularly prominent.The harm of primary lung adenocarcinoma has become prominent and it is an important disease that has a serious impact on human health.In this paper,we retrospectively studied the clinical and pathological features of primary pulmonary adenocarcinoma patients,including the difference of clinicopathological features between ground glass mass and solid mass,the operation methods,lymph node metastasis,rehabilitation time and prognosis.This study aims to provide clinical reference for the diagnosis and treatment of lung adenocarcinoma.Methods:We retrospectively analyzed the clinical data of 343 lung cancer patients undergone tumor resection at the Chinese Academy of Medical Sciences from January 2011 to January 2016,including age,gender,smoking history,tumor nature(grinding glass or solid),operation methods and lymph node metastasis.The patients were followed up for 5 years,and the loss of follow-up,death caused by other reasons during the study or survival at the follow-up were the censored value,and the total survival period was the time from tumor diagnosis to follow-up deadline or the death time.The data were analyzed by SPSS21.0 software,and the general information of the solid nodules group and the ground glass nodules group were analyzed by the chi-square test,and the survival rate was estimated by Kaplan-Meier method,and the survival rate significant test was made by the Log-rank,and the Cox regression model was used for multivariate analysis,and the survival curve was drawn,and the P<0.05 was shown for significant difference in statistics.Results:1.There were 254 cases(74.05%)of the asymptomatic physical examination and 89 cases(25.85%)with symptomatic physical examination among the 343 patients,including cough,chest tightness,chest pain,hemoptysis,multiple body discomfort and other clinical manifestations.There were 56 cases(16.33%)of patients with cought and 15 cases(4.37%)with chest tightness,8 cases(2.33%)with chest pain,multiple discomfort(1.75%)and hemoptysis(1.17%)as the first symptom.2.The imaging data of 343 cases of non-adenocacinoma patients were sorted,and the imaging findings showed that there were 274 patients with pure ground glass opacities with the symptoms of bronchial signs,shape,lobes and burrs.And there were 198 cases of pure ground glass opacity with 28 cases of AIS,81 cases of MIA and 89 cases of LPA,and there were 76 cases of mixed ground glass opacity and 69 patients shown the solid nodules with 34 cases of acinar adenocarcinoma,11 cases of LPA,9 cases solid type,3 cases of papillary type,10 cases of invasive mucinous adenocarcinoma and 2 cases of colon cancer,and there was no preinvasive lesions.CT showed there were ground glass opacities and the tumor size was commonly ≤ 2 cm in the tissue degree preinvasive lesions.3.The results of general data comparison in the solid nodules group and the ground glass nodules group showed that there was no statistically significant difference in the gender,age,lesion location,smoking history,surgical methods and surgical approach between the two groups,but there were statistically significant difference in the data of the tumor size,tumor differentiation,TNM staging,lymph node metastasis(P<0.05).4.There was no significant correlation between the survival rates of 69 patients with lung adenocarcinoma and solid nodules at the 1st,3rd and 5th year and the gender,age,lesion location,smoking history,surgical methods and surgical approach,but there was significant correlation with the tumor size,tumor differentiation and tumor TNM staging.5.The age,gender,tumor size,lesion location,smoking history,tumor differentiation,surgical methods,surgical approach,TNM staging and lymph node metastasis and other factors in the single factor analysis were analyzed by the Cox proportional hazards model,and the results showed that the tumor size,tumor low differentiation degree,TNM staging and lymph node metastasis or not were independent risk factors for prognosis of lung adenocarcinoma.6.The survival curves drawn according to the tumor size showed that the survival rates at 1st,3rd and 5th year and the median survival time were 96.67%、86.67%and 83.33%and 36 months respectively in the patients with tumor diameter less than 2 cm,and were 89.74%、76.92%and 58.97%and 24 months respectively in the patients with tumor diameter greater than 2 cm,therefore the survival time of the patients with tumor diameter less than 2 cm was significantly longer than patients with tumor diameter more than 2 cm(P<0.05).The survival rates at 1st,3rd and 5th year and the median survival time were 86.96%、56.52%and 34.78%and 12 months in the patients with low degree of tumor differentiation,and were 94.12%、91.18%and 85.29%and 36 months in the patients with medium degree of tumor differentiation,and were 100.0%、100.0%and 91.67%and 36 months in the patients with high degree of tumor differentiation,therefore with the increase of the degree of tumor differentiation,the survival time was increased gradually(P<0.05).The survival rates at 1st,3rd and 5th year and the median survival time were 100.00%、92.50%、82.50%and 91.67%、79.17%、62.50%and 36 months in the patients with tumor TNM staging of Ⅰ～Ⅱ1hstage,and were50.0%、0.0%、0.0%and 33.33%、0.0%、0.0%and 12 months in the patients with tumor TNM staging of Ⅲ～Ⅳ。stage,therefore with the increase of TNM staging,the survival time was significantly decreased(P<0.05).The survival rates at 1st,3rd and 5th year and the median survival time were 75.00%、37.50%and 12.50%and 12 months in the patients with tumor metastasis,and were 98.11%、94.34%and 86.79%and 36 months in the patients without tumor metastasis,and the survival time of the patients with lymph node metastasis was significantly lower than that in the patients without lymph node metastasis(P<0.05).Conclusion:1.There are significant differences in tumor size,tumor differentiation,TNM staging and lymph node metastasis between the solid nodule s group and the ground glass nodules group.2.The results of multivariate analysis shows that tumor size,tumor differentiation,TNM staging and lymph node metastasis were independent risk factors for prognosis of patients with lung adenocarcinoma.3.Lung adenocarcinoma patients with tumor diameter greater than 2 cm,high degree of tumor differentiation,late tumor TNM staging and lymph node metastasis occurrence should be given positive attention,and the various physiological indexes and imaging characteristics should be timely detected for early detection and early treatment,thereby improving the prognosis of patients. 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