Features Based on Thin-section Computed Tomography Identify the Typeof lung Adenocarcinoma

Abstract Background: To investigate whether thin-section computed tomography (TSCT) features may efficiently guide the invasiveness basedclassification of lung adenocarcinoma. Methods: Totally, 316 lung adenocarcinoma patients (from 2011-2015) were divided into three groups: 56 adenocarcinoma in situ (AIS), 98 minimally invasive adenocarcinoma (MIA), and 162 invasive adenocarcinoma (IAC) according their pathological results. Their TSCT features, including nodule pattern, shape, pleural invasion, solid proportion, border, margin, vascular convergence, air bronchograms, vacuole sign, pleural indentation, diameter, solid diameter, and CT values of ground-glass nodules (GGN) were analyzed. Pearson’s chi-square test, Fisher’s exact test and One-way ANOVA were adopted tocomparebetweengroups. Receiver operating characteristic (ROC) analysis wereperformedto assess its value for prediction and diagnosis. Results: Patients with IAC were significantly elder than those in AIS or MIA group,and more MIA patients had a smoking history than AIS and IAC. No recurrence happened in the AIS and MIA groups, while 4.3% recurrences were confirmed in the IAC group. As for TSCT variables, we found AIS group showed dominantly higher 91.07%PGGN pattern and 87.50% round/oval nodules than that in MIA and IAC group. In contrast, MIA group showed more cases with undefined border and vascular convergence than AIS and IAC group. Importantly, IAC group uniquely showed higher frequency of pleural invasion compared with MIA and AIS group. The majority of patients (82.1%) in IAC group showed ≥ 50% solid proportion. We found diameter and solid diameter of the lesions were notably larger in the IAC group compared with AIS and MIA groupin quantitative aspect. In addition, for MGGNs, the CT values of ground-glass opacity (GGO) and ground-glass opacity solid portion (GGO-solid) were both higher in the IAC group than AIS and MIA. Finally, we also observed that smooth margin took a dominant proportion in the AIS group while most cases in the IAC group had a lobulate margin. Patients in MIA and IAC group shared higher level of air bronchograms and vacuole signs than AIS group. Conclusions: The unique features in different groups identified by TSCT had diagnosis value for lung adenocarcinoma.

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Lung Adenocarcinoma Invasiveness Risk in Pure Ground-Glass Opacity Lung Nodules Smaller than 2 cm

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1612615 ◽

2018 ◽

Vol 67 (04) ◽

pp. 321-328 ◽

Cited By ~ 8

Author(s):

Geun Dong Lee ◽

Chul Hwan Park ◽

Heae Surng Park ◽

Min Kwang Byun ◽

Ik Jae Lee ◽

...

Keyword(s):

Lung Cancer ◽

Lung Adenocarcinoma ◽

Wedge Resection ◽

Ground Glass Opacity ◽

Ground Glass ◽

Maximum Diameter ◽

Lung Nodules ◽

Adenocarcinoma In Situ ◽

Invasive Adenocarcinoma ◽

Maximal Diameter

Background We aimed to identify clinicopathologic characteristics and risk of invasiveness of lung adenocarcinoma in surgically resected pure ground-glass opacity lung nodules (GGNs) smaller than 2 cm. Methods Among 755 operations for lung cancer or tumors suspicious for lung cancer performed from 2012 to 2016, we retrospectively analyzed 44 surgically resected pure GGNs smaller than 2 cm in diameter on computed tomography (CT). Results The study group was composed of 36 patients including 11 men and 25 women with a median age of 59.5 years (range, 34–77). Median follow-up duration of pure GGNs was 6 months (range, 0–63). Median maximum diameter of pure GGNs was 8.5 mm (range, 4–19). Pure GGNs were resected by wedge resection, segmentectomy, or lobectomy in 27 (61.4%), 10 (22.7%), and 7 (15.9%) cases, respectively. Pathologic diagnosis was atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IA) in 1 (2.3%), 18 (40.9%), 15 (34.1%), and 10 (22.7%) cases, respectively. The optimal cutoff value for CT-maximal diameter to predict MIA or IA was 9.1 mm. In multivariate analyses, maximal CT-maximal diameter of GGNs ≥10 mm (odds ratio, 24.050; 95% confidence interval, 2.6–221.908; p = 0.005) emerged as significant independent predictor for either MIA or IA. Estimated risks of MIA or IA were 37.2, 59.3, 78.2, and 89.8% at maximal GGN diameters of 5, 10, 15, and 20 mm, respectively. Conclusion Pure GGNs were highly associated with lung adenocarcinoma in surgically resected cases, while estimated risk of GGNs invasiveness gradually increased as maximal diameter increased.

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Radiopathologic correlation of collision lung cancer with ground-glass opacity

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492318811549 ◽

2018 ◽

Vol 27 (1) ◽

pp. 45-48

Author(s):

Shinsuke Uchida ◽

Koji Tsuta ◽

Masahiko Kusumoto ◽

Kouya Shiraishi ◽

Takashi Kohno ◽

...

Keyword(s):

Lung Cancer ◽

Ground Glass Opacity ◽

Ground Glass ◽

Adenocarcinoma In Situ ◽

Invasive Adenocarcinoma ◽

Ki 67 ◽

Lung Cancers ◽

Collision Tumors ◽

Minimally Invasive Adenocarcinoma ◽

Epidermal Growth

Pulmonary collision tumors have been described as a special entity of synchronous multiple lung cancer. There have been no reports detailing the chronological changes in primary collision lung cancers on chest computed tomography. We report a case of ground-glass lung nodules gradually colliding with each other. The collision tumors of the lung were composed of minimally invasive adenocarcinoma and adenocarcinoma in situ with epidermal growth factor mutations. Immunohistochemically, the Ki-67 labeling indices were different in the 2 components. Ki-67 staining was useful to distinguish the 2 components. The 2 dominant ground-glass tumors grew slowly with radiologic and pathologic heterogeneity.

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