Received:30 April 2020,
Published:15 October 2020
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Xiaoqun HE, Tianyou LUO, Xian LI, et al. Analysis of clinicopathology and CT features of histology subtypes of invasive lung adenocarcinoma[J]. Journal of Third Military Medical University, 2020, 42(19): 1950-1956.
Xiaoqun HE, Tianyou LUO, Xian LI, et al. Analysis of clinicopathology and CT features of histology subtypes of invasive lung adenocarcinoma[J]. Journal of Third Military Medical University, 2020, 42(19): 1950-1956. DOI: 10.16016/j.1000-5404.202004321.
Objective
2
Objective To investigate the differences of clinicopathological characteristics and CT features in different histology subtypes of invasive lung adenocarcinoma (ILA)
and to find a noninvasive imaging method that can help to distinguish them.
Methods
2
A total of 422 patients confirmed with solitary ILA by surgical resection in our hospital from July 2013 to July 2019 were included. All patients were divided into group A (those with a lepidic/acinar/papillary predominant pattern) and group B (those with a solid/micropapillary predominant pattern) according to the main pathological growth pattern. Moreover
group A was divided into group A1 (those with a lepidic predominant pattern) and group A2 (those with an acinar / papillary predominant pattern). The clinicopathology and CT features between group A and group B as well as those between group A1 and group A2 were compared
respectively.
Results
2
1Comparison of clinicopathological characteristics between group A and B: Gender and smoking history of patients
as well as histologic differentiation
lymph node metastasis status and pathologic TNM stage of tumors significantly differed between the two groups (all
P
<
0.05). Patients with male and smoking
tumors with poor histology differentiation
lymph node metastasis
and pathologic TNM stage of III-IV were more frequently seen in group B. However
no significant difference in the distant metastasis was observed between the two groups (
P
>
0.05). 2Comparison of CT features between group A and B: Lesion size
density
vascular convergence sign
air bronchogram
calcification
necrosis and pleural effusion were associated with the histological subtypes (all
P
<
0.05). Tumors in Group B were significantly larger than those in Group A. In addition
tumors with solid density
calcification
necrosis and pleural effusion were more frequently observed in Group B
whereas those with vascular convergence sign and air bronchogram were more common in Group A. However
no significant associations were found between other CT features and histological subtypes
including the distribution of tumors
air space
speculation
lobulation
and pleural retraction (all
P
>
0.05). 3Comparison of clinicopathological characteristics and CT features between group A1 and A2: Tumors with subsolid density were more common in Group A1
while those with solid density were more common in Group A
2 (
P
<
0.001). However
no significant differences were found in other clinicopathological characteristics and CT features between the two groups (all
P
>
0.05).
Conclusion
2
For clinicopathological characteristics
male
smoking
poor histology differentiation
lymph node metastasis
and pathologic TNM stage of III-IV were more common in patients with a solid/micropapillary predominant pattern. For CT features
tumors with large size
solid density
calcification
necrosis and pleural effusion were more common in patients with a solid/micropapillary predominant pattern
whereas those with vascular convergence sign and air bronchogram were more common in patients with a lepidic/acinar/papillary predominant pattern.
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