Relationship Between CT Imaging Data And Pathology Of Early Lung Adenocarcinoma

Objective To analyze the internal relationship between the imaging features of multiple computed tomograph y(CT)and postoperative pathological t ypes of earl y lung adenocarcinoma,so as to provide a basis for clinical diagnosis and treatment of earl y lung adenocarcinom a.Methods A total of 150 patients who met the inclusion criteria in thoracic surgery in our hospital from January 2014 to December 2018 were divided into three groups according to the po stoperative pathological t ypes: adenocarcinoma in situ(AIS),micro invasive adenocarcinoma(M IA)and stage Ⅰ A invasive adenocarcinoma cancer(IAC).At the same time,the preoperative computed tomography(CT)imaging data of each case were derived from the CT workstation,and the imaging characteristics were measured and recorded.The specific indicators include: average size,average CT value,nature of nodules,proportion of solid components,lobulation sign,spiculation sign,boundary clarit y,vascular sign,air bronchus sign,nodule shape,densit y,vacuole sign,pleura l indentation sign.The statistical data are divided into two categories: measurement data and counting data.SPSS19.0 software is used to anal yze the data of the three groups.Results There were 26 patients in AIS group,54 patients in MIA group and 70 patients in stage Ⅰ A IAC group,there was no significant difference in nodule shape,densit y,vacuole sign,vascular change and pleural indentation sign among the three groups.There were significant differences in average nodule size,mean CT value,nodula r nature,proportion of solid components,lobulation sign,spiculation sign,boundary clarit y and air bronchial sign among the three groups(P < 0.05).Among them,the average size of nodules in stage Ⅰ A IAC group was(16.93 ±6.06)mm,which was larger than that in MIA group(10.55 ±3.90)mm and AIS group(8.11 ±2.52)mm,(P < 0.074).According to t he receiver operating characteristic curve(ROC)curve anal ysis of th e former two groups,the best cut-off value was 11.5.The average CT value of stage Ⅰ A IAC group(-473.71 ±31.96)Hu,was significantl y higher than that of M IA group(-537.75 ±46.22)Hu and AIS group(590.15 ±42.35)Hu,.The ROC curve anal ysis of the former two groups showed that the best truncation value was-521.7 Hu,and the best truncation value of the latter two was-579.5 Hu.Most of the nodules in AIS group and M IA group were pure ground glass nodules(p GGN),but the latter also had some solid components.Most of the nodules in stage Ⅰ A IAC group were mixed ground glass nodules(m GGN),and the proportion of solid components in stage Ⅰ A IAC group was more than that in M IA group,and the best cut-off value was 0.65 b y ROC curve anal ysis.The proportion of spiculation sign,air bronchia l sign and boundary clarit y in stage Ⅰ A IAC group was higher than that in AIS group and M IA group,but there was no difference between the latter two groups.In stage Ⅰ A,the lobulation sign of IAC group and MIA group was more than that of AIS group,and there was no difference between the former two groups.Conclusion There was a certain correlation between the chest CT features and the pathological types of earl y lung adenocarcinoma.among them,the average size,mean CT value,nature of nodules,proportion of solid components,lobulation sign,spiculation sign,clear boundary and air bronchial sign were significantl y different among the three groups.When the average diameter of the nodule is more than 11.5mm,the average CT value is more than-521.7 Hu,the propert y is m GGN and the proportion of solid components is mor e than 0.65,when the nodule has lobulation sign,spiculation sign,air bronchial sign and tumor-lung boundary is clear,it is often considered as stage Ⅰ A IAC;.When the mean diameter of nodules is less than 11.5mm,the proportion of solid components is less than 0.65 mm,or when the average CT value of p GGN,is less than 521.7HU,with spiculation sign,air bronchial sign,and clear tumor-lung interface,it can be considered as AIS or M IA;,and when the average CT value of nodules is less than-579.5HU,the nature is p GGN,unlobulated sign,which is mostl y considered as AIS;.When the average CT value is between-521.7Hu and-579.5Hu,the nature is p GGN or with a few solid components,lobulation sign,mostl y considered as M IA;but the clinical disease is compl ex,doctors should comprehensivel y consider all kinds of patients before making diagnosis to avoid misdiagnosis.