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Published on: May 23, 2015
Early Lung Adenocarcinoma Manifesting as Irregular Subsolid Nodules: Clinical and CT Characteristics
Pei-Ling Zou1, Chao-Hao Ma2, Xian Li3
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China (P.-l.Z., T.-y.L., F.-j.L., Q.L.); Department of Radiology, Shapingba Hospital affiliated to Chongqing University, Chongqing, China (P.-l.Z.).
Rationale And Objectives:
To explore the clinical and computed tomography (CT) characteristics of early-stage lung adenocarcinoma (LADC) that presents with an irregular shape.
Materials And Methods:
The CT data of 575 patients with stage IA LADC and 295 with persistent inflammatory lesion (PIL) manifesting as subsolid nodules (SSNs) were analyzed retrospectively. Among these patients, we selected 233 patients with LADC and 140 patients with PIL, who showed irregular SSNs, hereinafter referred to as irregular LADC (I-LADC) and irregular PIL (I-PIL), respectively. The incidence rates, clinical characteristics, and CT features of I-LADC and I-PIL were compared. Additionally, binary logistic regression analysis was performed to determine the independent factors for diagnosing I-LADC.
Results:
The incidence rates of I-LADC and I-PIL were 40.5% (233/575) and 47.5% (140/295), respectively, with no statistically significant difference observed between the two groups (P > 0.05). Univariate analysis revealed significant differences in three clinical characteristics and 13 radiological features between I-LADC and I-PIL (all P < 0.05). Binary logistic regression indicated that the alignment of the long axis of SSN with the bronchial vascular bundle, a well-defined boundary of ground-glass opacity, lobulation, arc concave sign, and absence of knife-like change were the independent predictors of I-LADC, yielding an area under the curve and accuracy of 0.979% and 93.5%, respectively.
Conclusion:
Early LADC presenting as SSNs is associated with a high incidence of irregular shape. I-LADC and I-PIL exhibited different clinical and imaging characteristics. A good understanding of these differences may be helpful for the accurate diagnosis of I-LADC.
