[Correlation analysis between imaging features and lymph node metastasis in T1a lung adenocarcinoma]

Area of Science:

• Oncology
• Thoracic Surgery
• Diagnostic Imaging

Background:

• Lung adenocarcinoma is a common type of lung cancer.
• Accurate prediction of lymph node metastasis is crucial for staging and treatment planning in early-stage lung cancer.
• Clinical stage T1a lung adenocarcinoma presents diagnostic challenges regarding lymph node involvement.

Purpose of the Study:

• To identify predictive factors for lymph node metastasis in patients with clinical stage T1a lung adenocarcinoma.
• To analyze the association between various clinical and imaging characteristics and lymph node metastasis.

Main Methods:

• Retrospective review of 271 patients with small peripheral lung adenocarcinoma nodules.
• Data collected included demographics, smoking history, tumor characteristics (size, imaging findings), and biomarkers (CEA, SUVmax).
• Univariate and multivariate analyses were performed to identify predictive factors for lymph node metastasis.

Main Results:

• Pure ground-glass opacity (GGO) nodules showed no lymph node metastasis.
• Mixed GGO and solid nodules had significantly higher rates of lymph node metastasis (6.0% and 30.1%, respectively).
• Tumor size > 1 cm, elevated carcinoembryonic antigen (CEA) > 5 µg/L, and PET-CT SUVmax > 5 were predictive factors.

Conclusions:

• Pure GGO nodules in T1a lung adenocarcinoma generally do not involve lymph nodes.
• Imaging findings (mixed GGO or solid nodules) are independent predictors of lymph node metastasis.
• Tumor size, CEA levels, and SUVmax also contribute to predicting lymph node metastasis risk.