The diagnostic value of follow-up CT in pulmonary nodules progressing to invasive adenocarcinoma
10.3969/j.issn.1002-1671.2025.10.013
- VernacularTitle:肺结节CT随访对浸润性腺癌的诊断价值
- Author:
Jia PENG
1
;
Wenqiang ZHONG
;
Kunwei LI
;
Binghui CHEN
Author Information
1. 中山大学附属第五医院放射科,广东 珠海 519000
- Publication Type:Journal Article
- Keywords:
lung nodule;
invasive adenocarcinoma;
computed tomography;
follow-up
- From:
Journal of Practical Radiology
2025;41(10):1652-1657
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the natural progression of pulmonary ground-glass nodule(GGN)to invasive adenocarcinoma(IAC)and the diagnostic value of follow-up CT.Methods A retrospective analysis was performed on 45 GGN in 45 patients who were followed up for more than 2 years,surgically resected and pathologically confirmed.They were divided into IAC group(n=25)and non-IAC group(n=20),and the clinical and imaging characteristics between the two groups were compared.Results Significant differences were observed in initial volume(P=0.025),initial mass(P=0.005),margin(P=0.027),and time to GGN progression(P=0.005)between the IAC group and the non-IAC group.Multivariate logistic regression analysis indicated that initial mass and time to GGN progression were independent predictors for the diagnosis of IAC.The receiver operating characteristic(ROC)curve analysis results revealed that when using a maximum Youden's index of 0.456,the optimal cutoff for time to GGN progression was 30 months,with a sensitivity of 75.0%and a specificity of 70.6%,and an area under the curve(AUC)of 0.761[95%confidence interval(CI)0.606-0.916](P=0.005).When the maximum Youden's index reached 0.615,the sensitivity,specificity and AUC of the logistic regression model in the diagnosis of IAC were 79.2%,82.4%,and 0.860(95%CI 0.743-0.977)(P=0.001),respectively.The calibration curves demonstrated an excellent consistency between predicted and observed probabilities.Conclusion The optimal observation window for GGN is 30 months,during which IAC generally progresses.Close monitoring is recommended after the initiation of lesion growth.
