The correlations between vascular and bronchial abnormality on high resolution CT and the invasiveness of lung adenocarcinoma in subsolid nodules / 中华放射学杂志

ABSTRACT

Objective@#To observe the vascular and bronchial abnormalities in subsolid nodules on high resolution CT (HRCT), and analyze its correlations with the classification and subtypes of lung adenocarcinoma.@*Methods@#Pathological and radiographic data of 315 surgically resected subsolid nodules (226 were pure ground-glass opacities, and 89 were part solid nodules with tiny solid components ≤ 6 mm) were retrospectively reviewed. The morphologic changes of the blood vessels and bronchia/bronchioles in ground-glass opacity on HRCT were evaluated, and their correlations with histopathology classification were analyzed. Chi-square test was performed for analysis of correlations with categorical variables, whereas the one-way ANOVA analysis was performed for analysis of correlations with continuous variables (e.g., lesion dimension).@*Results@#Forty-eight pre-invasive lesions (PILs), 29 minimally invasive adenocarcinomas (MIAs), and 238 invasive adenocarcinomas (IACs) were analyzed. IACs were divided into 2 groups according to the percentage of lepidic pattern: lepidic predominant (lepidic pattern ≥ 50%, n=145), and non-lepidic predominant (lepidic patten<50%, n=93). The prevalence of vascular and bronchial abnormalities was higher in IACs (59.24% & 18.49% in IACs, 13.79% & 3.45% in MIAs, and 0% & 0% in PILs). The abnormalities of vessels and bronchi in nodules on HRCT were correlated with the PIL/MIA/IAC classifications (χ2=69.797, P<0.001, χ2=14.213, respectively). Moreover the prevalence of valcular and bronchial abnormalities significantly increased from non-lepidic predominant IACs (78.49%, 26.88%) compared to lepidic predominant IACs (46.90%, 13.10%), these morphologic abnormalities correlated with a higher percentage of non-lepidic pattern, which were considered with higher invasiveness, in IACs (P<0.001, χ2=22.139, P=0.012, χ2=6.253, respectively).@*Conclusion@#The morphologic changes of blood vessels and bronchia/bronchioles within the subsolid nodules on HRCT help to differentiate IAC from PIL and MIA, also correlate with the proportion of non-lepidic pattern in IACs, even when the solid component undeveloped or very tiny.