Correlation Of MSCT Signs And Pathological Features In Peripheral Invasive Lung Adenocarcinoma

Objective:To explore the relationship between MSCT imaging and five pathological subtypes of invasive pulmonary adenocarcinoma on the basis of 2015 edition WHO lung tumor histological classification criteria,which provide a reference for clinical treatments.Methods: By collecting the clinical and pathological data of 352 patients with peripheral lung adenocarcinoma who went through surgical excision and were pathologically confirmed of invasive adenocarcinoma in the First Affiliated Hospital of Qingdao University from October 2015 to October 2016.According to the 2015 edition WHO lung tumor histological classification criteria,the pathological subtypes of invasive pulmonary adenocarcinoma were divided into five groups:solid group,micro-papillary group,papillary group,acinar groupandepidic group.The main histological subtypes of invasive lung adenocarcinoma wereclassified according to the difference of prognosis of lung adenocarcinoma.Grade 1corresponded to the lepidic pattern of invasive adenocarcinoma.Grade 2 included tumors that showed papillary andacinar patterns.Grade 3 included the tumors that showed micro-papillary and solid patterns.Statistical analysis of the differences between the five groups in age,gender,the location,size and spiculation,lobulation sign,vacuole sign,density,air bronchogram,cavity and cystic change pleural indentation,vascular convergence and Strengthening degree were made in this study by adopting Chi-square test and rank sumtest.Statistic analysis using Spearman rank correlation method,Kruskal-Wallis test,Bonferroni test,Chi-squaretest or Fishertest.Results: Male accounted for 42.6% and female accounted for 57.4% among 352 cases;Age rang 40 to 81.The average age was 60.6±8.7.Lepidic group accounted for 15%,acinar group accounted for 56%,papillary group accounted for 12%,solid group accounted for 8%,and micro-papillary groupaccounted for 9%.The size,lobulation sign and air bronchogram between different types had a significant difference(P<0.05).The size of lesion in lepidic roup was smaller than that in other four types.The existence of lobulation sign inlepidic group was lower than that in other four types.The air bronchogram in acinar group was higher than that in other four types,there was no significant differences between other four type.There were statistically significant in grade1,grade 2 and grade 3 in terms of lesions in the grinding of solid component proportion(P<0.01).There was statistically significant in the CT value between the Grade 1,Grade 2 and Grade 3 the levels of in the patients with invasive adenocarcinoma before and after dynamic contrast enhanced(P<0.05).There were no significant differences in the gender,location,spiculation,the cavity,pleural indentation,vascular convergence and tumors with cyst-like appearance between the lepidic group,acinargroup,papillary group,micro-papillary group,and solid group(P>0.05).Conclusion:The results showed that MSCT imagings were different between five pathological subtypes of invasive pulmonary adenocarcinoma.The size of lesion in epidic group was smaller than that in other types,and there was a tendency to show lobulation sign in other four types than in epidic group.Air bronchogram was inclined to exist in acinar group than in other types.The more solid composed,the higher the pathological level have.