Quantitative Analysis Of Imaging-Pathological Related Factors In 59 Cases Of Pure Ground Glass Nodules

Objective:Quantitative analysis was made on the pathological components of the pulmonary imaging manifestations of pure ground glass nodules.The role of each component in the formation of CT values was discussed.The best cut-off values of each component in the prediction of invasive adenocarcinoma were analyzed.Quantitative study was made on the feature extraction of AI pathological images.Methods:From January,2016 to December,2017,59 cases of pulmonary adenocarcinoma diagnosed by pathology in the First Affiliated Hospital of Anhui Medical University with Pure ground glass nodules were selected.According to the pathological results of lung adenocarcinoma,the experimental group was divided into three groups: adenocarcinoma in situ,minimally invasive adenocarcinoma and invasive adenocarcinoma.To compare the correlation between the CT value of lung adenocarcinoma nodules and the four pathological components,namely Collagen fibrosis,Elastic fibers,alveolar cavity macrophage content and alveolar septal width;Under the same diagnosis of lung adenocarcinoma,the pathological results were divided into two groups: invasive lung adenocarcinoma group and non-invasive lung adenocarcinoma group.(Including in situ adenocarcinoma and micro-invasive adenocarcinoma),the size of cancer nodules,CT value,Collagen fibrosis content,Elastic fibers content,alveolar macrophage content and alveolar septum width were selected as indicators to study their predictive effect on invasive adenocarcinoma,and ROC curve was drawn to find the best truncation value for evaluation.Results: 59 cases of pure ground glass nodules included 20 cases of adenocarcinoma in situ(34%),19 cases of micro-invasive adenocarcinoma(32%)and 20 cases of invasive adenocarcinoma(34%).The mean values of the maximum cross-sectional diameters of adenocarcinoma in situ,minimally invasive adenocarcinoma and invasive adenocarcinoma were(0.73 ± 0.33)cm,(1.15 ± 0.37)cm and(1.48 ± 0.46)cm,respectively,and P < 0.05,There were significant differences among the three groups.The mean CT values of adenocarcinoma in situ,minimally invasive adenocarcinoma and invasive adenocarcinoma were(-667±114)HU,(-634±98)HU,(-495±136)HU,respectively,The difference was statistically significant,and P<0.05.The linear correlation analysis of Collagen fibrosis content,Elastic fibers content,alveolar macrophage content,alveolar septal width and CT value was made,among which Collagen fibrosis content and Elastic fibers content were not linearly correlated with CT value,P>0.05.There was a linear regression relationship between CT value and alveolar septum(P<0.05,regression coefficient was 8.7);there was a linear regression relationship between CT value and macrophage content(P <0.05,regression coefficient was-2.0).In the evaluation of invasive and non-invasive adenocarcinomas,the cut-off value of the maximum cross-sectional diameter was 12 mm,the sensitivity was 70.00%,the specificity was 79.49%,and the area under the curve was 0.80,(P < 0.05,95% CI:0.68-0.90).The CT value of IAC group was significantly higher than that of AIS and MIA group,and the maximum truncation value was-540 HU,the sensitivity was 65%,the specificity was 89.74%,and the area under curve was 0.81,(P<0.05;95% CI:0.68-0.90).The maximum truncation value of alveolar septal width was 23 um,the sensitivity was 90.0%,the specificity was 64.1%,and the area under curve was 0.77,(P<0.05;95% CI: 0.64-0.87).The maximum cut-off value of CFs for predicting invasive cancer was 0.143(14.3%),sensitivity was 95%,specificity was 79.49%,and area under curve was 0.90,(P<0.05;95% CI: 0.79-0.96).Conclusions:Alveolar septal width and macrophage content in pulmonary adenocarcinoma nodules constitute part of the pathological basis of CT value changes,and have linear regression relationship with CT value of nodules.The best cut-off values of tumor size,CT mean value of pulmonary nodules,percentage of collagen fibers and alveolar septal width for predicting invasive adenocarcinoma are 12 mm,-540 HU,14.3% and 23 μm,respectively.The combination of features may be of great significance in the diagnosis of invasive adenocarcinoma.Increased alveolar septal width will increase the risk of developing into micro-invasive carcinoma in situ adenocarcinoma.Increased collagen content and alveolar septal width will increase the risk of developing into invasive carcinoma in situ.