Predictive value of radiological features on spread through air spaces in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity
- VernacularTitle:影像学特征对 cⅠA 期磨玻璃为主型肺腺癌肺泡腔内播散的预测价值
- Author:
Zhan LIU
1
;
Zhenrong ZHANG
2
;
Hongxiang FENG
2
;
Weipeng SHAO
1
;
Xinlei GU
3
;
Hongliang SUN
4
;
Deruo LIU
2
Author Information
1. Department of General Thoracic Surgery, China-Japan Friendship Hospital, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, 100029, P.R.China
2. Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing, 100029, P.R.China
3. Department of Thoracic Surgery, Peking University International Hospital, Beijing, 102206, P.R.China
4. Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, P.R.China
- Publication Type:Journal Article
- Keywords:
Lung tumor;
adenocarcinoma;
radiology;
ground-glass opacity;
spread through air spaces
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(01):19-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of preoperative radiological features on spread through air spaces (STAS) in stage cⅠA lung adenocarcinoma with predominant ground-glass opacity, and to provide a basis for the selection of surgical methods for these patients. Methods The clinical data of 768 patients with stage cⅠA lung adenocarcinoma undergoing operation in our hospital from 2017 to 2018 were reviewed, and 333 early stage lung adenocarcinoma patients with predominant ground-glass opacity were selected. There were 92 males and 241 females, with an average age of 57.0±10.0 years. Statistical analysis was performed using SPSS 22.0. Results STAS-positive patients were mostly invasive adenocarcinoma (P=0.037), and had more micropapillary component (P<0.001) and more epidermal growth factor receptor (EGFR) gene mutations (P=0.020). There were no statistically significant differences between the STAS-positive and STAS-negative patients in other clinicopathological features. Univariate analysis showed that the maximum diameter of tumor in lung window (P=0.029), roundness (P=0.035), maximum diameter of solid tumor component in lung window (P<0.001), consolidation/tumor ratio (CTR, P<0.001), maximum area of the tumor in mediastinum window (P=0.001), tumor disappearance ratio (TDR, P<0.001), average CT value (P=0.001) and lobulation sign (P=0.038) were risk factors for STAS positive. Multivariate logistic regression analysis showed that the CTR was an independent predictor of STAS (OR=1.05, 95%CI 1.02 to 1.07, P<0.001), and the area under the receiver operating characteristic (ROC) curve was 0.71 (95%CI 0.58 to 0.85, P=0.002). When the cutoff value was 19%, the sensitivity of predicting STAS was 66.7%, and the specificity was 75.2%. Conclusion CTR is a good radiological feature to predict the occurrence of STAS in early lung adenocarcinoma with predominant ground-glass opacity. For the stage cⅠA lung adenocarcinoma with predominant ground-glass opacity and CTR ≥19%, the possibility of STAS positive is greater, and sublobar resection needs to be carefully considered.
