Purpose
To evaluate the clinicopathologic characteristics and prognosis of
patients with clinical stage IA lung adenocarcinoma with atypical solid
nodules (ASNs) on thin-section CT images.
Materials and Methods
Data from patients with clinical stage IA lung adenocarcinoma who
underwent resection between January 2005 and December 2012 were
retrospectively reviewed. According to their manifestations on
thin-section CT images, nodules were classified as ASNs, subsolid
nodules (SSNs), and typical solid nodules (TSNs). The clinicopathologic
characteristics of the ASNs were investigated, and the differences
across the three groups were analyzed. The Kaplan-Meier method and
multivariable Cox analysis were used to evaluate survival differences
among patients with ASNs, SSNs, and TSNs.
Results
Of the 254 patients (median age, 58 years [IQR, 53–66]; 152 women)
evaluated, 49 had ASNs, 123 had SSNs, and 82 had TSNs. Compared with
patients with SSNs, those with ASNs were more likely to have nonsmall
adenocarcinoma (
P
< .001), advanced-stage
adenocarcinoma (
P
= .004), nonlepidic growth
adenocarcinoma (
P
< .001), and middle- or
low-grade differentiation tumors (
P
< .001).
Compared with patients with TSNs, those with ASNs were more likely to
have no lymph node involvement (
P
= .009) and epidermal
growth factor receptor mutation positivity (
P
= .018).
Average disease-free survival in patients with ASNs was significantly
longer than that in patients with TSNs (
P
<
.001) but was not distinguishable from that in patients with SSNs
(
P
= .051).
Conclusion
ASNs were associated with better clinical outcomes than TSNs in patients
with clinical stage IA lung adenocarcinoma.
Keywords:
Adenocarcinoma, Atypical Solid Nodules, CT,
Disease-free Survival, Lung, Prognosis, Pulmonary
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article
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Published under a CC BY 4.0 license.