Objective To investigate the value of radiological and clinical features in predicting preoperatively spread through air spaces(STAS)in early-stage lung adenocarcinoma,and to provide patients with early-stage lung adenocarcinoma the reference in choice of the operation method.Methods The radiological and clinical data of 264 patients with resection of the pulmonary nodules were analyzed retrospectively,and the spicule sign,pleural indentation sign,vessel convergence sign,lobulated sign,vacuole sign,consolidation-to-tumor ratio(CTR)and general clinical data were analyzed.Results There were 110 cases with STAS positive and 154 cases with STAS negative.There were significant differences in smoking history,spicule sign,pleural indentation sign,and CTR between STAS positive and STAS negative(P＜0.05).CTR≥18.2％was an independent risk factor by logistic analysis.Conclusion CTR≥18.2％is an independent risk factor of STAS positive,while pulmonary nodules with spicule sign,pleural indentation sign and CTR≥18.2％are highly suspected STAS positive in smoking history patients,providing evidence in surgical method choice for patients with early-stage lung adenocarcinoma.