The value of CT features in differentiating moderately and highly differentiated invasive adenocarcinoma in pure ground glass nodule

doi:10.11958/20220292

Abstract

Abstract:

Objective To investigate the value of CT signs in differentiating pure ground glass nodule (pGGN) between moderately differentiated and highly differentiated invasive adenocarcinoma (IAC). Methods The clinical data of 83 patients with IAC and imaging data of 84 pGGNs were retrospectively collected. According to the pathological results, patients were divided into the highly differentiated group (46 lesions of lepidic dominant type, 45 patients) and the moderately differentiated group (38 lesions of acinar or papillary dominant type, 38 patients). The clinical data and CT features of pGGN were compared between the two groups, and the factors influencing the differentiation degree and diagnostic value in patients were analyzed. Results There were significant differences in maximum diameter, mean CT value, burrs, abnormal vascular signs and abnormal bronchus signs between the moderately differentiated group and the highly differentiated group (P<0.05). Multivariate Logistic regression analysis showed that the higher mean CT value and abnormal vascular signs were important influencing factors in the prediction of moderately differentiated IAC, and the odds ratios (95% confidence interval) were 1.042 (1.022-1.062) and 5.869 (1.105-31.161) respectively. ROC curve analysis showed that in the combined diagnosis of mean CT value and abnormal vascular signs, the area under the curve of moderately differentiated IAC was 0.903 (0.842-0.964), the efficiency was 0.870, the sensitivity was 0.789. The diagnostic efficacy and sensitivity were higher than the mean CT value, but the diagnostic specificity of average CT value was higher. Conclusion The combined diagnosis of mean CT value and abnormal vascular signs has high predictive value for moderately differentiated IAC with pGGN on CT.

Key words: lung neoplasms, pure ground-glass nodule, non-mucinous lung adenocarcinoma, computed tomography

CLC Number:

Figures/Tables 6

References 21

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组别	n	年龄（岁）	性别（男/女）	吸烟史
高分化组	45	57.1±9.2	14/31	12（26.7）
中分化组	38	56.2±10.1	8/30	4（10.5）
t或χ²		0.441	1.070	3.449

组别	n	年龄（岁）	性别（男/女）	吸烟史
高分化组	45	57.1±9.2	14/31	12（26.7）
中分化组	38	56.2±10.1	8/30	4（10.5）
t或χ²		0.441	1.070	3.449

组别	n	最大直径（cm）	平均CT值（HU）	分叶征	毛刺征	异常血管征	异常支气管征	空泡征	胸膜凹陷征
高分化组	46	1.35（1.10,1.53）	-573.0±55.8	28（60.9）	14（30.4）	20（43.5）	16（34.8）	14（30.4）	13（28.3）
中分化组	38	1.50（1.10,2.00）	-481.8±52.5	22（57.9）	24（63.2）	28（73.7）	24（63.2）	14（36.8）	12（31.6）
Z、t或χ²		1.969^＊	7.656^＊＊	0.076	8.995^＊＊	7.753^＊＊	6.717^＊	0.384	0.110

组别	n	最大直径（cm）	平均CT值（HU）	分叶征	毛刺征	异常血管征	异常支气管征	空泡征	胸膜凹陷征
高分化组	46	1.35（1.10,1.53）	-573.0±55.8	28（60.9）	14（30.4）	20（43.5）	16（34.8）	14（30.4）	13（28.3）
中分化组	38	1.50（1.10,2.00）	-481.8±52.5	22（57.9）	24（63.2）	28（73.7）	24（63.2）	14（36.8）	12（31.6）
Z、t或χ²		1.969^＊	7.656^＊＊	0.076	8.995^＊＊	7.753^＊＊	6.717^＊	0.384	0.110

变量	β	SE	Wald χ²	P	OR（95%CI）
平均CT值	0.041	0.010	17.178	<0.001	1.042（1.022~1.062）
异常血管征	1.770	0.852	4.316	0.038	5.869（1.105~31.161）
异常支气管征	0.027	0.848	0.001	0.974	1.028（0.195~5.420）
最大直径	0.788	0.664	2.360	0.124	3.167（0.917~9.638）
毛刺征	0.753	0.751	1.003	0.316	2.123（0.487~9.258）
常数项	22.589	5.696	15.724	<0.001	6 459 421 837.000