Correlations Between Pathologic Classification/EGFR Mutation And CT Characteristics Of Lung Adenocarcinoma With Ground Glass Nodules

Part 1: Correlations between pathologic classification and CT characteristics of lung adenocarcinoma with ground glass nodules Objective: To discuss the correlation between pathologic classification and CT features of lung adenocarcinoma with ground glass nodules(GGNs).Methods: CT appearances of 124 patients who underwent curative resection of lung adenocarcinoma with GGNs were analyzed in terms of mean diameter,volume,density,margin lobular,margin spiculated,tumor-lung interface,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign,lymphadenectasis,distant metastasis,hydrothorax and ground glass proportion.Pathologic classification were classified into preinvasive lesions(atypical adenomatous hyperplasia and adenocarcinoma in situ)and invasive lesions(minimally invasive adenocarcinoma and invasive pulmonary adenocarcinoma).Patients' age,lesions' mean diameter,volume and density were compared with pathologic classification using nonparametric Wilcoxon tests.Patients' gender,margin lobular,margin spiculated,tumor-lung interface,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign,lymphadenectasis,distant metastasis,hydrothorax and ground glass proportion were compared with pathologic classification using X2 test.The variables that exhibited statistically significant differences were included in a logistic regression analysis.And then establish prediction model.Receiver operating characteristic(ROC)analyses were conducted for the variables that exhibited statistically significant differences in the logistic regression.Result: The patients' gender,age,tumor-lung interface,lymphadenectasis,distant metastasis and hydrothorax were not significantly different among different histopathologic subtypes(P>0.05),whereas the lesions' mean diameter,volume,density,margin lobular,margin speculated,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign and ground glass proportion showed significant differences(P<0.05).The results of logistic regression showed that lesions' mean diameter?volume?density and ground glass proportion were important distinguishable factors.And their invasion predicted value Y= =2.919+0.166×mean diameter +0.011×density.ROC analysis showed that the optimal cutoff value of mean diameter was 15.25mm(sensitivity 80.0%,specificity 85.2%),the optimal cutoff value of density was-553.85HU(sensitivity88.6%,specificity 75.9%),the optimal cutoff value of invasion predicted value was 1.173(sensitivity 74.3%,specificity98.1%).Conclusion: Of lung adenocarcinoma with GGNs,the lesions' mean diameter,volume,density,margin lobular,margin spiculated,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign and ground glass proportion have a high predictive value for estimating the degree of invasion.Among them,mean diameter and density has the highest predictive value.Part 2: Correlations between EGFR mutation and CT characteristics of lung adenocarcinoma with ground glass nodules Objective: To discuss the correlation between EGFR mutation and CT features of lung adenocarcinoma with ground glass nodules(GGNs).Methods: CT appearances of 62 patients who underwent curative resection of lung adenocarcinoma with GGNs were analyzed in terms of mean diameter,volume,density,margin lobular,margin spiculated,tumor-lung interface,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign,lymphadenectasis,distant metastasis,hydrothorax,ground glass proportion and growth rate.Patients' age,lesions' mean diameter,volume,density and growth rate were compared with EGFR mutation using nonparametric Wilcoxon tests.Patients' gender,margin lobular,margin spiculated,tumor-lung interface,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign,lymphadenectasis,distant metastasis,hydrothorax and ground glass proportion were compared with EGFR mutation using X2 test.Result: The patients' gender,age,mean diameter,volume,density,margin lobular,margin spiculated,tumor-lung interface,bubble-like sign,air bronchogram,pleural tag,vessel convergence sign,lymphadenectasis,distant metastasis,hydrothorax and ground glass proportion were not significantly different between the EGFR mutation group and the non-mutation group(P>0.05).Average growth rate of the EGFR mutation group is 0.062±0.107cm3/d,average growth rate of the non-mutation group is 0.009±0.013cm3/d,there are significant differences(P=0.026).In preinvasive lesions and invasive lesions,there were no significant differences in CT appearances except the growth rate between the EGFR mutation group and the non-mutation group.Conclusion: Of lung adenocarcinoma with GGNs.Lesions' with EGFR mutation grow quicker than the non-mutation group.No matter whether the lesion is invisive or not,there were no significant differences in CT appearances except the growth rate in the EGFR mutation group and the non-mutation group.