Correlation Between Internal CT Manifestations And Pathologic Subtypes Of Lung Adenocarcinoma With Pure Ground-glass Opacity

Part ? Correlation between Vessel Changes within Lesion and Histopathologic Subtypes of Lung Adenocarcinoma with Pure Ground-glass Opacity on Computed TomographyObjective To investigate the correlation between vessel changes within lesion and the histopathologic subtypes of lung adenocarcinoma with pure ground-glass nodule (pGGN) on computed tomography (CT).Methods One hundred and ninety patients (201 lesions) of lung adenocarcinomas with pGGN who underwent curative resection were included. Vessel changes included vascular convergence and/or vessel dilation or distortion within the pGGN. According to the vessel appearances within the pGGN, all patients were categorized into two groups:no change group and change group. Pearson Chi square test was used to analyze the relationships between vessel changes and histopathologic subtypes. Mann-Whitney rank test and t-test were used to identify the correlation of vessel changes with the density and diameter of pGGN.Results A total of 201 pGGNs were enrolled. There were 31 without vessel changes and 4 with vessel changes in 35 pre-invasive lesions; 27 without vessel changes and 26 with vessel changes in 53 MIAs; 33 without vessel changes and 80 with vessel changes in 113 ILAs. There were statistically significant differences of vessel changes (P=0.000) among histopathologic subtypes, while there were no significant difference between vessel convergence and vessel dilation or distortion among these three groups (P=0.115). The lesion diameter was significantly different between the no change and change groups (P=0.000), while the lesion density was not different (t=1.033,P=0.303).Conclusion Vessel changes may indicate the invasiveness of lung adenocarcinoma with pGGN and were correlated with the lesion diameter.Part ? Histopathologic implications of abnormal air bronchogram of pure ground glass lung adenocarcinoma on computed tomographyObjective To analyze the value of abnormal air brochogram for predicting the invasiveness of lung adenocarcinoma with pGGN.Methods From April 2014 to February 2016,157 patients with pure ground-glass lung adenocarcinoma confirmed by surgical pathology were selected and CT characteristics including lesion size, density, abnormal air bronchogram were recorded. According to bronchiolar changes or not, all lesions were divided into two groups, respectively. Chi-Square test was used to analyze the relationship between bronchus change and pathological subtypes. Mann-Whitney rank test and t-test were used to analyze the correlation of abnormal air bronchogram with size and density of pGGN. A P-value less than 0.05 was considered to be statistically significant.Results Of 85 lesions with air bronchogram in total, there were 12 lesions in 30 pre-invasive lesions (AAH+AIS),17 in 39 minimally invasive adenocarcinomas (MIAs),56 in 96 invasive lung adenocarcinomas (ILAs) (P=0.113). The lesions with air bronchogram were divided into two groups:abnormal (bronchus change) and normal (no bronchus change) air bronchogram. Abnormal air bronchogram were demonstrated in 61 of 85 lesions with air bronchogram, and 1 in 30 pre-invasive lesions(AAH+AIS),13 in 39 MIAs,47 in 96 ILAs (P=0.000). There was a significant difference in diameter of lesions between two groups (P=0.000), but not in density (P=0.966).Conclusion Abnormal air bronchogram can predict the invasiveness of pGGN lung adenocarcinoma, and is correlated with lesion size, but not with density.