Radiological Features And Clinicopathological Characteristics Analysis Of Subcentimeter Pulmonary Nodules

Objective:This study retrospectively analyzed and discussed the imaging features and clinicopathological characteristics of subcentimeter pulmonary nodules(≤10 mm in diameter)to provide some reference basis for clinicians to manage subcentimeter pulmonary nodules.Method:General clinical data(gender,age,smoking history,alcohol history,personal or family history of tumor),imaging data(imaging size,nodule density,growth location,imaging characteristics)and pathological data(pathological size,pathological characteristics)were collected from patients with surgically treated and pathologically definite subcentimeter pulmonary nodules between January 2020 and December 2022 at the Department of Thoracic Surgery,China-Japan Friendship Hospital of Jilin University.The data were processed using SPSS 25.0 software.The independent sample t-test and nonparametric rank sum test were used for the measurement data.P<0.05 was considered a statistically significant difference.Result:There were 148 patients in this group,87 female patients and 61 male patients,with a median age of 55 years(54.20±9.69).Among the148 subcentimeter lung nodules diagnosed by postoperative pathology,95 were malignant nodules with a mean diameter of 8.0(7.8-10.0)mm,55 were invasive adenocarcinoma,29 were microinvasive adenocarcinoma,6 were in situ adenocarcinoma,2 were neuroendocrine carcinoma,and 3 were atypical carcinoid;53 were benign nodules with a mean diameter of 7.7(7.0-8.0)mm,24 were inflammatory nodules There were 8 cases of intrapulmonary lymph nodes,17 cases of atypical adenomatous hyperplasia,3 cases of sclerosing pneumocytoma,and 1case of bronchial adenoma.Among the imaging features of the two groups,nodule imaging size(p=0.01),nodule density(p=0.002),lobar sign(p=0.038)and vacuolation sign(p=0.005)were statistically different.The optimal diagnostic cut-off value for sub-centimeter lung nodule size was 9.0 mm,which had a sensitivity of 84.3%,specificity of 41.3%,positive predictive value of 28.4%,and negative predictive value of78.3%.And among the clinical characteristics,the differences were statistically significant in smoking history(p=0.043)and previous tumor history(p=0.02).Conclusion:There is an association between subcentimeter lung nodule imaging features and nodule benignity and malignancy.In this study,the incidence of malignant subcentimeter lung nodules was significantly higher compared to benign subcentimeter lung nodules.For patients with a history of smoking,previous tumor history of pulmonary nodules,or nodules with lobar or vacuolar signs,nodule size ≥ 9 mm,and density of mixed ground glass on CT have a high possibility of malignancy,which will help clinicians to screen out nodules with high malignant potential from subcentimeter lung nodules for closer follow-up or aggressive surgical intervention.