The Correlations Between HRCT Features And Pathological Classification And PD-L1 Expression In Lung Adenocarcinoma

Objective: To analyze the relation between high resolution CT(HRCT)signs and the expression of pathological subtypes as well as that between HRCT signs and programmed death ligand 1(PD-L1)in lung adenocarcinoma.Methods: 147 patients were pathologically confirmed as lung adenocarcinoma,and were divided into preinvasive group(PI),minimally invasive adenocarcinoma group(MIA)and invasive adenocarcinoma group(IAC).89 patients were tested for PD-L1 immunohistochemistry,and were divided into the PD-L1 positive group and the PD-L1 negative group.we statistically analyzed the clinical features and HRCT signs.Results: There was no significant difference in the location,vacuole sign and vascular convergence sign among PI group,MIA group and IAC group.The proportion of women in PI group was higher than those in the MIA group and IAC group.Compared with MIA group and IAC group,PI group was smaller in age and diameter,lower carcinoembryonic antigen(CEA),incidence of lobulated shape sign,clear lung-tumor interface and spiculated sign.The density of the PI group was lower than that of the MIA group,and the density of the MIA group was lower than that of the IAC group.The incidence of air bronchus sign and pleural indentation sign in IAC group was higher than that in MIA group.The incidence of vascular convergence sign was lower in the group with lepidic adenocarcinoma than in the group with acinar adenocarcinoma.IAC with lepidic pattern group has a higher proportion of females than without lepidic pattern group.The incidence of air bronchus sign in IAC with papillary pattern group was higher than that in IAC without papillary pattern group.The density of IAC without lepidic pattern grouping,with solid pattern grouping and with micropapillary pattern grouping was higher than that of IAC with lepidic pattern grouping,without solid pattern grouping and without micropapillary pattern grouping.Compared with the PD-L1 negative group,the PD-L1 positive group had a larger diameter and higher density,and the incidence of clear lung-tumor interface,lobulated shape sign,spiculated sign and pleural indentation sign is higher.The PD-L1 positive rate of IAC was higher than MIA.Conclusion: The clinical features and HRCT signs are of great significance in differentiating the pathological subtypes of lung adenocarcinoma from the expression of PD-L1.