Correlation Between CT Features And Pathological Features Of Lung Adenocarcinoma With A Diameter Lower Than 1cm

Objective:To study the correlation between CT signs and pathological subtypes of lung adenocarcinoma with ground glass density less than 1 cm and immunohistochemistry,so as to explore the differences of CT signs in different pathological subtypes of lung adenocarcinoma.Methods:CT,clinical and pathological data of 202 patients with lung adenocarcinoma diagnosed by operation from March 2016 to October 2018 were retrospectively collected.There were 92 males and 110 females,ranging in age from 30 to 78 years,with an average age of(60.2±9.8)years.Surgical excision and pathological evidence were adopted in all cases.The general indicators(sex,age)of the patient and the location,diameter,size,CT mean value,preinvasive and invasive lesions,tumor-lung interface,lobulation,burr,vascular cluster or thickening,vacuole symptoms,air-bronchus sign,vascular cluster sign,pleural depression,umbilical depression symptoms,shape of the lesion,margin and boundary of the lesion were expanded.So as to compare the CT signs and immunohistochemical correlation of different histopathological subtypes of lung adenocarcinoma.Results:(1)38 cases of AAH,66 cases of AIS,38 cases of MIA and 60 cases of IPA;(2)The number of right lung lesions was 52 more than that of left lung lesions,and the number of upper lung lesions was 33 more than that of lower lung lesions,but there was no significant difference in the location of lesions between different pathological subtypes(P>0.05);(3)The average diameter of lesions in AAH group was(0.81 ±0.18)cm,AIS group was(0.89±0.14)cm,MIA group was(0.93 ±0.12)cm,IPA group was(0.96 ±0.09)cm.With the increase of malignant degree of lesions(from AAH to IPA),the size of lesions increased,and the difference has statistically significant(P<0.05).The average size of pre-invasive lesions(AAH+AIS)was(0.81±0.13)cm,and the invasive lesions(MIA+IPA)was(0.87 ±0.16)cm.(4)The average CT value of AAH group was(-531.2 ±119.3)HU,AIS group was(-498.3± 152.7)HU,MIA group was(-472.6±21.9)HU,IPA group was(-470.3±120.2)HU.There was no significant difference in the density index of different pathological subtypes of internal lesions(P>0.05);(5)With the increase of malignancy(from AAH to IPA),the occurrence probability of vascular cluster sign in different pathological subtypes of AAH,AIS,MIA and IPA was 42.1%,47.0%,50.0%and 68.3%,respectively.The difference has statistically significant(P<0.05).At the same time,there were statistical differences between AAH and AIS,MIA and IPA(P<0.05).There was no statistical difference in vacuole sign and air bronchus sign between different pathological subtypes(P>0.05);(6)There was no statistical difference in lesion shape among different pathological subtypes(P>0.05).(7)The proportion of lesions with clear lung-lung interface was AAH:34.20%;IPA:42.4%;MIA:78.90%;IPA:85.00%;and the difference has statistically significant.Preinvasive lesions(AAH+AIS):39.4%,invasive lesions(MIA+IPA):82.6%;and the difference has statistically significant(P=0.039,P<0.05).There was a significant difference in the appearance of clear tumor-lung interface in different pathological types.It can be seen that the clearer the tumor-lung interface is,the more malignant the lesion is.There was no statisticsdifference in the margins of lesions(i.e.smooth,burr,lobulation and lobulation+burr)among pathological subtypes(P>0.05).(8)There statisticsdifferences in the expression of HER-1 at lung interface and immunohistochemistry,the expression of Ki-67 and HER-2 in round,oval and irregular shape on CT,and the expression of HER-2 in vacuole sign(P<0.05).Conclusion:CT signs and pathological subtypes of lung adenocarcinoma with ground glass density less than 1 cm are correlated with immunohistochemistry,and the location,size,tumor-lung interface,homogeneity,margin and air bronchus sign of the lesion have prominent predictive functions for pathological classification.