Study Of Correlation Between Pathological Subtypes Of Lung Adenocarcinoma And HRCT Imaging Features

Objective:To investigate the correlation between the pathological subtypes of lung adenocarcinoma and their HRCT imaging features.It is hoped that by understanding the main predictors of pathological subtypes of lung adenocarcinoma,we can provide some reference for clinical diagnosis and treatment,and provide some data supplement for the development of intelligent imaging diagnosis in the future.Methods:A total of 100 patients with postoperative pathology confirmed lung adenocarcinoma with HRCT imaging data within 1 month before operation were collected from Qinghai University Affiliated Hospital from January 2016 to September 2019.According to the latest WHO(2015)classification criteria for lung adenocarcinoma histology,them were divided into four groups: atypical adenomatous hyperplasia(AAH)group,adenocarcinoma in situ(AIS)group,microinvasive adenocarcinoma(MIA)group and invasive adenocarcinoma(IAC)group.The data relating to pathological subtypes of lung adenocarcinoma,such as sex,age,maximum diameter,CT value,location,sign of lobulation,burr sign,pleural traction sign,air bronchogram and vacuole sign were compared and statistically analyzed.Results: The age,maximum diameter index were tested by variance F,the CT value index by nonparametric rank sum test,the location and vacuole sign index by Fisher accurate test,and the sex,lobulation sign,burr sign,pleural stretch sign and air bronchogram by chisquare test.Single factor analysis showed that the difference of the maximum diameter,CT value,sign of lobulation,burr sign,pleural traction sign and air bronchogram were statistically significant(P <0.05).And then the meaningful indicators into multiple regression model to do multi-factor Logistic regression analysis.Four groups of pathological subtypes were used as reference,and results show that the significant indicator between AAH?AIS is the maximum diameter,significant indicators between AAH?MIA are maximum diameter,CT value and bronchial inflatable sign,significant indicators between AAH?IAC are maximum diameter,CT value,air bronchogram and burr sign,the significant indicator between AIS?MIA is the CT value,significant indicators between AIS?IAC are maximum diameter,CT value and burr sign,and significant indicators between MIA?IAC are maximum diameter,CT value and burr sign.The probability that the patient belongs to AIS?MIA and IAC is significantly increased for each additional unit of the maximum diameter for AAH(OR>1,P<0.05),and the probability of IAC higher than MIA higher than AIS.Also the probability of the patient belonging to AAH was 0.955 of the MIA probability(OR =0.955,P <0.05),the probability of belonging to AIS is 0.959 of that of MIA(OR =0.959,P <0.05),and the probability of belonging to IAC is 1.085 of that of MIA(OR =1.085,P <0.05)for each additional unit of the CT value for MIA.Conclusion: The AAH?AIS is mainly related to the maximum diameter and CT value,MIA to the maximum diameter,CT value and air bronchogram,IAC to the maximum diameter,CT value,air bronchogram and burr sign.With the increase of maximum diameter and CT value,pathological subtypes gradually evolved from AAH to IAC.And understanding the correlation between pathological subtypes of lung adenocarcinoma and HRCT imaging features is instructive for the choice of surgical methods and can provide some data supplement for the database needed for the development of intelligent imaging diagnosis.