Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, United States.
Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, United States.
Lung Cancer. 2018 Apr;118:83-89. doi: 10.1016/j.lungcan.2018.01.013. Epub 2018 Feb 3.
The International Association for the Study of Lung Cancer, American Thoracic Society and European Respiratory Society lung adenocarcinoma classification in 2011 defined three lepidic predominant patterns including adenocarcinoma in situ, minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma. We sought to correlate the radiology and pathology findings and identify any computed tomography (CT) features which can be associated with invasive growth.
An institutional review board approved, retrospective study was conducted evaluating 63 patients with resected, pathologically confirmed, adenocarcinomas with predominant lepidic patterns. Preoperative CT images of the nodules were assessed using quantitative and qualitative radiographic descriptors while blinded to pathologic sub-classification and size. Maximum diameter was measured after evaluation of the axial, sagittal and coronal planes. Radiologic - pathologic associations were examined using Fisher's exact test, the Kruskal-Wallis test and the Spearman correlation coefficient (ρ).
Increasing maximum diameter of the whole lesion (ground glass and solid component) on CT was significantly associated with invasiveness (p = .003), as was the maximum pathologic specimen diameter (p = .008). Larger diameter of the solid component on CT was also found in lepidic predominant adenocarcinoma compared to minimally invasive adenocarcinoma (median 10.5 vs 2 mm, p = .005). More invasive tumors had higher visual estimated percentage solid component compared to whole lesion measurement on CT (p = .014). CT and pathologic measurements were positively correlated, although only moderately (ρ = .66) for the maximum whole lesion size and fair (ρ = .49) for solid/invasive component maximum measurements. Larger whole lesion size and solid component size of lepidic predominant pattern adenocarcinomas are associated with lesion invasiveness, although radiologic and pathologic lesion measurements are only fair-moderately positively correlated.
2011 年国际肺癌研究协会、美国胸科学会和欧洲呼吸学会的肺腺癌分类将三种以贴壁生长为主的模式定义为肺腺癌，包括原位腺癌、微浸润性腺癌和以贴壁生长为主的腺癌。我们试图对影像学和病理学发现进行相关性分析，并确定与浸润性生长相关的任何 CT 特征。
一项机构审查委员会批准的回顾性研究，评估了 63 例经手术切除、病理证实、以贴壁生长为主的腺癌患者。对结节的术前 CT 图像使用定量和定性的影像学描述符进行评估，同时对病理亚分类和大小进行盲法评估。在评估了轴位、矢状位和冠状位后测量最大直径。使用 Fisher 确切检验、Kruskal-Wallis 检验和 Spearman 相关系数（ρ）来检验影像学-病理学相关性。
CT 上整个病变（磨玻璃和实性成分）的最大直径的增加与侵袭性显著相关（p=0.003），最大病理标本直径也与侵袭性显著相关（p=0.008）。与微浸润性腺癌相比，贴壁生长为主的腺癌中 CT 上实性成分的最大直径也更大（中位数 10.5 与 2mm，p=0.005）。与 CT 上整个病变测量值相比，侵袭性肿瘤的实性成分目测估计百分比更高（p=0.014）。尽管 CT 和病理测量值之间呈正相关（最大整个病变大小的相关系数为 ρ=0.66，实性/侵袭性成分最大测量值的相关系数为 ρ=0.49），但相关性仅为中等偏强。贴壁生长为主的腺癌中较大的整个病变大小和实性成分大小与病变的侵袭性相关，尽管影像学和病理学病变测量值仅呈中等偏强的正相关。
