Purpose To evaluate the CT features and pathological manifestations of the solid components of mixture ground-glass opacity (GGO) in adenocarcinoma in situ (AIS), minimally invasive adenocarcinom (MIA) and invasive adenocarcinoma (IAC), to analyze the qualitative diagnosis value of solid components of mixture GGO in the diagnosis of AIS, MIA and IAC, to provide reference for the selection of clinical treatment.Materials and Methods Eighteen patients with AIS, 53 patients with MIA and 28 patients with IAC (the maximum diameter smaller than 2 cm) proved by surgery and pathology with CT features appearing as mixture GGO were retrospectively analyzed, CT features of the solid components in three groups were analyzed and compared with pathology.Results The solid components in AIS mainly appeared as punctiform or polygon, with extensive distribution, solid nodules were usually single (17 cases, 94.44%), located in the middle of the lesion (14 cases, 77.78%), with clear binderies (16 cases, 88.89%) and the same density with vessels in the same axis (13 cases, 72.22%); the majority of solid components in MIA appeared as circular or elliptical (33 cases, 62.26%), less than or equal to 5 mm (48 cases, 90.57%), with eccentric or multi-point distribution (45 cases, 84.90%), the boundaries were less sharp (40 cases, 75.47%), with slightly lower density than that of the vasculars in the same level (34 cases, 64.15%); the solid components in IAC mainly appeared as irregular lesions (21 cases, 75.00%), lager than 5 mm (24 cases, 85.71%), with eccentric growth (20 cases, 71.43%) and less sharp boundary (15 cases, 53.57%), the integration of multiple nodules could also be observed. There were statistically significant differences in the CT features of solid components within the lesions among the three groups (P<0.01).Conclusion It is possible to predict the pathological typing and the prognosis of pulmonary mixture GGO in a certain extent according to the different CT features of the solid components in it, and to guide clinical treatment principles.

Purpose To explore the independent predictors of malignant solitary pulmonary nodule (SPN) manifesting as ground-glass nodule (GGN),and to establish a prediction model.Materials and Methods The clinical data and CT images of 362 patients (group A) with pathological-confirmed SPN appearing as GGN in Shanghai Chest Hospital Shanghai Jiaotong University from January 2014 to December 2015 were retrospectively analyzed.The independent predictors of malignant SPN were identified,and the clinical prediction model was established.Another 119 SPN patients in Affiliated Zhoushan Hospital of Wenzhou Medical University were selected as group B to verify the diagnostic efficiency of the prediction model.Results Using multivariate Logistic regression analysis,clear border (OR=6.274,P＜0.01),smooth edge (OR=0.391,P＜0.01),lobulation (OR=3.387,P＜0.01),pleural retraction sign (OR=2.430,P＜0.01),and vocule sign (OR=3.076,P＜0.01)were identified as independent predictors of malignant SPN.The area of the model under the ROC curve was 0.859 with 95％ CI (0.804-0.903).The diagnostic accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.92％,91.03％,81.97％,92.03％ and 73.53％,respectively.Conclusion In this study,the independent predictors of malignant SPN appearing as GGN were identified,and the prediction model was established.The model can accurately identify SPN and provide effective help for early diagnosis of SPN.

Objective:To systematically evaluate the efficacy and safety of precision thoracic radiotherapy (TRT) in the limited-stage small cell lung cancer (LS-SCLC) patients by network meta-analysis.Methods:Randomized controlled trials (RCTs) of TRT regimes in the LS-SCLC were electronically searched from PubMed, Web of Science, The Cochrane Library, CNKI and Wanfang Data from inception to September 1 st, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed by Stata 17 and R 4.1.1 software. Results:A total of 6 RCTs involving 1730 patients with six radiation regimens including hyperfractionated radiotherapy (HFRT): HFRT 45(45 Gy/30 F) and HFRT 60(60 Gy/40 F); conventional fractionated radiotherapy (CFRT): CFRT 70(70 Gy/35 F) and CFRT 66(66 Gy/33 F); moderately hypofractionated radiotherapy (MHFRT): MHFRT 65(65 Gy/26 F) and MHFRT 42(42 Gy/15 F) were included. The network meta-analysis showed that: in terms of improving progression-free survival and overall survival, there was no statistically significant difference among the six radiotherapy regimens. The probabilistic ranking results were: MHFRT 65> HFRT 60>CFRT 66>CFRT 70>MHFRT 42>HFRT 45, and HFRT 60>MHFRT 65>CFRT 66>CFRT 70>HFRT 45>MHFRT 42, respectively. The HFRT 60 regimen was superior to other regimens in reducing the incidence of grade ≥3 pneumonia, and there was no difference between the regimens in causing grade ≥3 radiation esophagitis, and the results of ranking probability were: HFRT 60> MHFRT 42>CFRT 66>CFRT 70>HFRT 45>MHFRT 65, and HFRT 60>CFRT 70>CFRT 66>HFRT 45>MHFRT 42>MHFRT 65, respectively. Conclusions:HFRT 60 radiotherapy regimen may be more effective and safer in the treatment of LS-SCLC patients as a priority choice for LS-SCLC TRT. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.