The Correlation Between CT Features And Pathology Of Ground-glass Nodules In Lung Adenocarcinoma

Objective:To analyze the CT features of ground-glass nodules and mixed-density ground-glass nodules in Lung Adenocarcinoma and to evaluate their value in the diagnosis of Atypical Adenomatous Hyperplasia(AAH)/in Situ Adenocarcinoma(AIS),microinvasive Adenocarcinoma(MIA)and invasive Adenocarcinoma(IAC).Method:Retrospective analysis was conducted on the data of 229 patients with lung adenocarcinoma who showed pure ground-glass nodules or mixed density ground-glass nodules on CT and were pathologically confirmed from August 2013 to April 2020 in the Third Affiliated Hospital of Xinjiang Medical University,and they were divided into three groups according to pathological types:AAH/AIS group,MIA group and IAC group.The size,density,location,lobulation sign,burr sign,vacuole sign,vascular shadow,air bronchus sign and pleural depression sign of ground glass nodules in each group were evaluated and statistically analyzed.Qualitative data were tested by Chi-square test and Fisher test,while quantitative data were tested by One-way ANOVA and non-parametric Krustal-Wallis H test.Receiver operating characteristic curve was drawn to analyze the accuracy of predicting factors of invasive adenocarcinoma.Results:The difference of mean diameter in aah/ais group,Mia group and IAC group was statistically significant(?2=65.40,P<0.05),and the difference of average CT value was statistically significant(?~2=38.57,P<0.05).The difference of leaf sign and burr sign was statistically significant in the three groups(P<0.05);There was significant difference in the pleural depression sign between aah/ais group,Mia group and IAC group(P<0.05),and there was significant difference between aah/ais group and IAC group(?2=14.842,P<0.017),and there was no significant difference between aah/ais group and Mia group and Mia group and IAC group(P>0.017);The combination of average diameter and average CT value has a high diagnostic value in aah/ais and IAC.In comparison with IAC group,the combined index was the same as that of the single application of average diameter.Conclusion:Mean diameter,mean CT value,lobulation sign,burr sign and pleural depression can be used as important CT imaging features to distinguish preinvasive lesions,microinvasive adenocarcinoma and invasive adenocarcinoma.