Clinical Difference Between Lung Adenocarcinoma In Situ And Minimally Invasive Adenocarcinoma

Objective: This study collected general clinical data and imaging findings in patients with adenocarcinoma in situ(AIS)and minimally invasive adenocarcinoma(MIA).This study analyzes the clinical features that contribute to the differential diagnosis of both AIS and MIA.Our goal was to improve clinicians' ability to diagnose and differentially diagnose AIS and MIA.Methods : This study collected the clinical data of 162 patients with pathologically confirmed AIS and MIA who underwent surgical treatment of pulmonary nodules found on the chest CT examination of the First Affiliated Hospital of Soochow University between January 2012 and February2017.There were 99 patients in the MIA group and 63 patients in the AIS group.The data collected in this study includes general clinical data such as the patient's gender,age,smoking history,past cancer history,and basic pulmonary disease history,as well as lung nodule size,location,shape,borderline clarity,burr sign,lobar sign,null Image characteristics of bubble signs,pulmonary nodule types(pure ground glass nodules,mixed density ground glass nodules,and solid nodules),bronchial air inflation signs,vascular convergence signs,and pleural recession signs.We used statistical methods to analyze whether there were statistical differences between different clinical features of patients with AIS and MIA,and to explore meaningful features for the diagnosis and differential diagnosis of AIS and MIA.Results:The proportion of patients with previous history of smoking,history of cancer,and underlying history of lung disease in the AIS and MIA groups was low,and there was no statistically significant difference between the two groups.The number of female patients in both groups was more than males,but there was no significant difference between the two groups in gender and the average age of the two groups of patients.There was no significant difference in the location of lung nodules,whether the upper lobe,shape,vacuole sign,and vascular bundle sign between the two groups.In this study,the diameter of lesions in patients with micro-invasive adenocarcinoma was greater than that of micro-invasive adenocarcinoma.The number of patients with marginal lesions in the micro-invasive adenocarcinoma group was greater than the number of patients with sharp edges in the comparison of whether the margins were clear or not,whereas the results were opposite in the adenocarcinoma in situ group.The percentage of lobulated signs in patients with micro-invasive adenocarcinoma was higher than that in adenocarcinoma in situ.In patients with micro-invasive adenocarcinoma,the proportion of partially solid nodules exceeds 50%,while the proportion of partially solid nodules and pure ground glass nodules in the orthotopic adenocarcinoma group is approximately similar.The proportion of broncho-pneumatic signs in patients with micro-invasive adenocarcinoma was significantly higher than that in adenocarcinoma in situ.The patients with pleural recession between the two groups were significantly more in the micro-invasive adenocarcinoma group than in the adenocarcinoma group.Conclusions:The general clinical features of the patient have limited price for differential diagnosis of AIS and MIA.Thoracic CT features of the patient are helpful in the differential diagnosis of AIS and MIA.Especially when the pulmonary nodules have large lesions and the boundary is blurred,there arebronchial bronchograms,pleural indwelling signs,and lobulated sign patterns had great clinical significance for the identification of AIS and MIA.