CT characteristics and their clinicopathological associations in ground-glass nodular multifocal lung adenocarcinoma

This study investigates the correlation between CT findings and clinicopathological features in patients with ground-glass nodular multifocal lung adenocarcinoma. A total of 203 lesions were identified and classified based on pathological results into 3 groups: preinvasive lesions (92 nodules), microinvasive adenocarcinoma (69 nodules), and invasive adenocarcinoma (42 nodules). CT imaging was performed on all patients, and the CT features were analyzed in relation to clinicopathological characteristics. Statistical analysis was performed using SPSS 22.0 software. Continuous variables were compared using one-way ANOVA or the Kruskal-Wallis test, while categorical variables were analyzed using the Chi-square test or Fisher exact test. Spearman correlation analysis was used to assess the relationship between CT features and clinicopathological characteristics. Significant differences were observed in nodule morphology, lobulation, vacuolation, burr sign, air bronchial sign, pleural indentation, tumor-lung interface, vascular characteristics, and ground-glass nodule type between the 3 groups (P < .05). The invasive adenocarcinoma group exhibited higher proportions of round/oval nodules, lobulation, vacuolation, burr sign, air bronchial sign, pleural depression, clear tumor-lung interface, vascular penetration, and partial solid nodules compared to the other 2 groups (P < .05). The microinvasive adenocarcinoma group showed a higher incidence of vacuolation, burr sign, pleural indentation, vascular penetration, and partial solid nodules than the preinvasive group (P < .05). No significant differences were found in the nodule locations among the groups (P > .05). The average size of nodules in the invasive group was significantly larger than in the other 2 groups (P < .05), while no difference was observed between the preinvasive and microinvasive groups (P > .05). The incidence of several CT signs, such as burr sign and pleural depression, negatively correlated with tumor differentiation (r = -0.311 to -0.378, all P < .05). The occurrence of pure ground-glass nodules was positively correlated with differentiation (R = 0.127, P < .05). Additionally, lesion characteristics like shape and lobulation were linked to lymph node metastasis (R = 0.313 to 0.415, P < .05). CT features in multifocal lung adenocarcinoma patients are closely related to pathological characteristics, providing valuable insights for clinical diagnosis and classification.