Correlation of computed tomography quantitative parameters with tumor invasion and Ki-67 expression in early lung adenocarcinoma

Abstract

The purpose of the study is to investigate the correlation of computed tomography (CT) quantitative parameters with tumor invasion and Ki-67 expression in early lung adenocarcinoma.The study involved 141 lesions in 141 patients with early lung adenocarcinoma. According to the degree of tumor invasion, the lesions were assigned into (adenocarcinoma in situ + minimally invasive adenocarcinoma) group and invasive adenocarcinoma (IAC) group. Artificial intelligence-assisted diagnostic software was used to automatically outline the lesions and extract corresponding quantitative parameters on CT images. Statistical analysis was performed to explore the correlation of these parameters with tumor invasion and Ki-67 expression.The results of logistic regression analysis showed that the short diameter of the lesion and the average CT value were independent predictors of IAC. Receiver operating characteristic curve analysis identified the average CT value as an independent predictor of IAC with the best performance, with the area under the receiver operating characteristic curve of 0.893 (P < .001), and the threshold of -450 HU. Besides, the predicted probability of logistic regression analysis model was detected to have the area under the curve of 0.931 (P < .001). The results of Spearman correlation analysis showed that the expression level of Ki-67 had the highest correlation with the average CT value of the lesion (r = 0.403, P < .001).The short diameter of the lesion and the average CT value are independent predictors of IAC, and the average CT value is significantly positively correlated with the expression of tumor Ki-67.Abbreviations: AAH = adenomatous hyperplasia, AI = artificial intelligence, AIS = adenocarcinoma in situ, AUC = area under the curve, CT = computed tomography, HRCT = high-resolution computed tomography, IAC = invasive adenocarcinoma, LUAD = lung adenocarcinoma, MIA = minimally invasive adenocarcinoma, ROC = receiver operating characteristic.

A metabolomics study on carcinogenesis of ground-glass nodules

“…Depending on the degree of tumor invasion, GGN can be classified as atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), or invasive adenocarcinoma (IAC). [ 1 , 6 ] The World Health Organization Classification of Tumors (5 th edition) has classified AAH and AIS as precursor glandular lesions, and MIA and IAC as LUADs. [ 7 ] The progression of malignancy from AAH to AIS, and then further to MIA and IAC is a dynamic process.…”

“…[ 8 ] The treatment options and prognosis of different GGN classifications are quite different. [ 6 ] AAH is a small localized lesion (≤0.5 cm diameter) with Clara cells and/or atypical proliferating type II alveolar pneumocytes and is generally considered benign. [ 9 , 10 ] Thus, patients with AAH may not need to undergo aggressive surgery.…”

“…[ 10 , 11 ] Prior research has shown the 5-year survival rate of AIS and MIA patients after surgical resection can be up to 100%. [ 6 , 10 - 12 ] IAC is an adenocarcinoma with ≥5 cm diameter and showing invasion to the pleura, blood vessels, and even lymphatics. [ 12 ] The 5-year survival rate of IAC patients after surgical resection has been reported as 74.6%, which is lower than that of AIS and MIA patients.…”

“…[ 12 ] The 5-year survival rate of IAC patients after surgical resection has been reported as 74.6%, which is lower than that of AIS and MIA patients. [ 6 ] Thus, early detection, diagnosis , and treatment of GGN are associated with good prognosis and patient outcomes. [ 13 ]…”