PMID- 37117233
OWN - NLM
STAT- MEDLINE
DCOM- 20230501
LR  - 20230510
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 13
IP  - 1
DP  - 2023 Apr 28
TI  - Thin-slice computed tomography enables to classify pulmonary subsolid nodules 
      into pre-invasive lesion/minimally invasive adenocarcinoma and invasive 
      adenocarcinoma: a retrospective study.
PG  - 6999
LID - 10.1038/s41598-023-33803-x [doi]
LID - 6999
AB  - The aim was to investigate the ability of thin-slice computed tomography (TSCT) 
      to differentiate invasive pulmonary adenocarcinomas (IACs) from 
      pre-invasive/minimally invasive adenocarcinoma (AAH-MIAs), manifesting as 
      subsolid nodules (SSNs) of diameter less than 30 mm. The CT findings of 810 
      patients with single subsolid nodules diagnosed by pathology of resection 
      specimens were analyzed (atypical adenomatous hyperplasia, n = 13; adenocarcinoma 
      in situ, n = 175; minimally invasive adenocarcinoma, n = 285; and invasive 
      adenocarcinoma, n = 337). According to the classification of lung adenocarcinoma 
      published by WHO classification of thoracic tumors in 2015, TSCT features of 368 
      pure ground-glass nodules (pGGN) and 442 part-solid nodules (PSNs) were compared 
      AAH-MIAs with IACs. Logistic regression and receiver operating characteristic 
      (ROC) curve analyses were performed. In pGGNs, multivariate analysis of factors 
      found to be significant by univariate analysis revealed that higher mean-CT 
      values (p = 0.006, OR 1.006, 95% CI 1.002-1.010), larger tumor size (p < 0.001, 
      OR 1.483, 95% CI 1.304-1.688) with air bronchogram and non-smooth margins were 
      significantly associated with IACs. The optimal cut-off tumor diameter for 
      AAH-MIAs lesions was less than 10.75 mm (sensitivity, 82.8%; specificity, 80.6%) 
      and optimal cut-off mean-CT value - 629HU (sensitivity, 78.1%; specificity, 
      50.7%). In PSNs, multivariate analysis of factors found to be significant by 
      univariate analysis revealed that smaller tumor diameter (p < 0.001, OR 0.647, 
      95% CI 0.481-0.871), smaller size of solid component (p = 0.001, OR 83.175, 95% 
      CI 16.748-413.079),and lower mean-CT value of solid component (p < 0.001, OR 
      1.009, 95% CI 1.004-1.014) were significantly associated with AAH-MIAs 
      (p < 0.05). The optimal cut-off tumor diameter, size of solid component, and 
      mean-CT value of solid component for AAH-MIAs lesions were less than 14.595 mm 
      (sensitivity, 71.1%; specificity, 83.4%), 4.995 mm (sensitivity, 97.8%; 
      specificity, 92.3%) and - 227HU (sensitivity, 65.6%; specificity, 76.3%), 
      respectively. In subsolid nodules, whether pGGN or PSNs, the characteristics of 
      TSCT can help in distinguishing IACs from AAH-MIAs.
CI  - (c) 2023. The Author(s).
FAU - Li, Min
AU  - Li M
AD  - Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, 241 Huaihai West Road, Xuhui District, Shanghai, 200030, China.
AD  - Department of Radiology, Shanghai Municipal Hospital of Traditional Chinese 
      Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
FAU - Zhu, Lei
AU  - Zhu L
AD  - Department of Pathology, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      241 Huaihai West Road, Xuhui District, Shanghai, 200030, China.
FAU - Lv, Yilv
AU  - Lv Y
AD  - Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, 241 Huaihai West Road, Xuhui District, Shanghai, 200030, China.
FAU - Shen, Leilei
AU  - Shen L
AD  - Department of Radiology, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      Shanghai, China.
FAU - Han, Yuchen
AU  - Han Y
AD  - Department of Pathology, Shanghai Chest Hospital, Shanghai Jiaotong University, 
      241 Huaihai West Road, Xuhui District, Shanghai, 200030, China. ychan@cmu.edu.cn.
FAU - Ye, Bo
AU  - Ye B
AD  - Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong 
      University, 241 Huaihai West Road, Xuhui District, Shanghai, 200030, China. 
      yb1373@shchest.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230428
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - *Lung Neoplasms/diagnostic imaging/pathology
MH  - Neoplasm Invasiveness/diagnostic imaging
MH  - *Adenocarcinoma/diagnostic imaging/pathology
MH  - *Adenocarcinoma of Lung/diagnostic imaging
MH  - *Multiple Pulmonary Nodules/diagnostic imaging
MH  - Tomography, X-Ray Computed/methods
PMC - PMC10147622
COIS- The authors declare no competing interests.
EDAT- 2023/04/29 06:04
MHDA- 2023/05/01 06:42
PMCR- 2023/04/28
CRDT- 2023/04/28 23:18
PHST- 2022/04/12 00:00 [received]
PHST- 2023/04/19 00:00 [accepted]
PHST- 2023/05/01 06:42 [medline]
PHST- 2023/04/29 06:04 [pubmed]
PHST- 2023/04/28 23:18 [entrez]
PHST- 2023/04/28 00:00 [pmc-release]
AID - 10.1038/s41598-023-33803-x [pii]
AID - 33803 [pii]
AID - 10.1038/s41598-023-33803-x [doi]
PST - epublish
SO  - Sci Rep. 2023 Apr 28;13(1):6999. doi: 10.1038/s41598-023-33803-x.