| Objective: To investigate the clinical imaging features of lung cancer patients with ground-glass opacity（GGO）on lung imaging,and to analyze the risk factors,evaluate the postoperative prognosis of patients,and select appropriate interventions for lung cancer.Method: A retrospective analysis was conducted from January 2016 to September 2020,high Resolution Computer Tomography（HRCT）was performed in 149 patients（158 lesions）who were diagnosed as lung cancer with less than or equal to 3 cm GGO and surgical resection at Jilin University.The gender,age,symptoms,smoking history,and tumor history of all patients were collected,and the average diameter,density,location,tumor-lung interface,spiculation sign,lobulation sign,vacuolar sign,air bronchus sign and pleural stretch sign of the lesions were analyzed by imaging features.A total of 158 GGOs were included in the study,including 62 proto-glandular Lesions,43 microinvasive adenocarcinoma,and 53 invasive adenocarcinoma.The relationship between clinical features and GGO imaging features and pathological types of patients was analyzed,and the risk factors affecting the prognosis of patients were analyzed.SPSS 23.0 statistical software was used for analysis.Results: AAH/AIS,MIA,IAC: A total of 149 patients were included in this study,including 17 cases of men and 132 cases of women,51 cases of symptomatic and 98 cases asymptomatic,24 cases with smoking history and 125 cases without smoking history,18 cases with tumor history,there were no significant differences in sex,symptom,smoking history and tumor history among the three groups（p > 0.05）,but GGO type lung cancer was common in the female patients without smoking history.The average age of the patients was 55.36±9.32 years.The age of the patients was 52.00±10.58 years and 57.26±7.97 years respectively,the age difference between the two groups was statistically significant（p < 0.05）.The results of imaging were as follows: The diameters of the three groups of lesions were 7.50（6.00~10.00）mm,11.00（9.00~13.00）mm,15.00（11.00~17.00）mm.Kruskai-Willis test showed that the size of the lesions was statistically significant（p < 0.05）.The majority of MIA and IAC lesions were m GGO（90.7%,96.2%）,AAH/AIS lesions were p GGO（58.1%）.There was significant difference among the three groups（p < 0.05）.Fisher exact probability method was used to test the difference of operation methods（p < 0.05）.The distribution locations of 158 lesions were 65 lesions in the right upper lobe,14 lesions in the right middle lobe,15 lesions in the right lower lobe,43 lesions in the left upper lobe,and 21 lesions in the left lower lobe.Chi-square test showed no significant difference among the three groups（p < 0.05）.The chi-square test of lung interface,spiculation sign,lobulation sign,vacuole sign,bronchus inflating sign and pleural traction sign among the three groups was statistically significant（p < 0.05）.Univariate analysis showed that age,GGO mean diameter,density,lung-tumor interface,spiculation sign,lobulation sign,vacuole sign,air-bronchus sign and pleural traction sign were statistically significant among the three groups,GGO Size（or = 0.764,p = 0.011）,GGO density（or = 7.862,p = 0.004）and no spiculation sign（or = 5.442,p = 0.012）were correlated with pathologic type between AAH/AIS and MIA.When the critical value of the lesion size is 10.50 mm,AUC=0.810,sensitivity=58.14%,specificity=88.71%,the combined AUC of lesion size,GGO density（AUC=0.744）and spicule sign（AUC=0.741）was AUC=0.896,that is,GGO size combined with density and spicule sign could better predict minimally minimally invasive adenocarcinoma.The tumor-lung interface was clear between IAC group and MIA group（or = 2.836,p = 0.047）;lobulated sign（or = 5.031,p = 0.004）;bronchial inflation sign（or = 4.110,p = 0.013）was correlated with pathological type.149 patients were followed up in December 2021,and the median follow-up time was 36（15-71）months.One of the patients was lost to follow-up 35 months after surgery,and the remaining patients have no recurrence,metastasis or death.The 1-year and 3-year OS rates of GGO patients with different pathological types,densities,and sizes were all 100%,and the prognosis of GGO-type lung cancer patients was better.Conclusion: 1.Lung cancer with radiographic manifestations of ground glass opacity has a better prognosis,there is no significant difference in the 3-year prognosis of patients with different pathological types,densities and sizes of ground-glass opacity lung cancer after operation.2.The majority of lung cancer patients with ground glass imaging were female non-smokers;Patients in the lung cancer group were older than those in the gland precursor lesion group.3.In AAH/AIS and MIA,GGO size,m GGO and spiculation sign were the main risk factors for MIA,and the combination of GGO size,m GGO and spiculation sign could better predict MIA.In IAC and MIA,clear tumor-lung interface,lobulation sign and bronchial inflation sign are the main risk factors for IAC. |
PDF Full Text Request