Analysis Of Risk Factors For Invasive Patterns Of Early-staged Lung Adenocarcinoma Manifesting As Ground-Glass Nodules

ObjectivesTo explore the risk factors of invasive patterns of early-staged lung adenocarcinoma manifesting as ground-glass nodules(GGN)and to provide reference for clinical decision-making.MethodsA retrospective study was performed for 68 patients with high-resolution computed tomography(HRCT)scan showing lesions of GGN,meanwhile post-operative pathology confirmed as atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS),minimally invasive adenocarcinoma(MIA)or invasive adenocarcinoma(IAC)in past one year,respectively.According to invasive patterns,the patients were divided into non-invasive group(including AAH,AIS and MIA,n=32)and invasive group(i.e.IAC,n=36).The clinical data,imaging data and postoperative pathological diagnosis were compared.ResultsThe difference regarding the spiculation sign(p=0.032),the lobulation sign(p=0.002)and the air bronchogram sign(p=0.041)was statistically significant between two groups.The maximum diameter(16.3±5.5 mm)and CT value(-434.4±153.9 HU)in the invasive group were significantly greater than the maximum diameter(8.62±3.14 mm)and CT value(-559.3±115.3 HU)in the non-invasive group(p<0.001).The ROC curve of continuous variables were made and the cut-off value were obtained using the Yoden index.The cut-off value for maximum diameter was 13.85 mm and the CT value was-487 HU,respectively.Multivariate analysis found that the CT attenuation value greater than-487 HU(OR=15.364;95% CI:2.386-98.939;p=0.004)was an independent risk factor for IAC.ConclusionAnalysis of the imaging features of early-staged lung adenocarcinoma manifesting as GGN on chest HRCT scan is helpful for comprehensively determining the degree of invasiveness.The CT value of GGN is an independent risk factor for invasive patterns of early-staged lung adenocarcinoma.