High-resolution CT features: prognostic significance in peripheral lung adenocarcinoma with bronchioloalveolar carcinoma components.
BACKGROUND
Based on Noguchi's classification, adenocarcinomas with bronchioloalveolar carcinoma (BAC) components have a heterogeneous prognosis. However, until now, the prognostic factors in this tumor category have not been clarified.


OBJECTIVE
We studied the prognostic significance of high-resolution CT (HRCT) findings in this tumor subtype.


METHODS
HRCT findings [lesion size, percentage of ground-glass opacity (GGO) areas in the lesion, presence or absence of lobulation, coarse spiculation, pleural tag, satellite lesion, air bronchogram, and site of the lesion], clinical data (age, gender and surgical method), and pathologic findings (degree of tumor differentiation and presence or absence of nodal metastasis) were analyzed in 52 consecutive patients with adenocarcinoma with BAC components <3 cm (mean, 1.7 cm). The patients included 32 women and 20 men with a mean age of 66 years. The results correlated with survival using univariate and multivariate analysis. The mean follow-up period was 41 months.


RESULTS
Nine (17%) of the 52 patients died of lung cancer. In univariate analysis, a significant difference was found for lobulation (p = 0.018), %GGO (p = 0.043), air bronchogram (p = 0.003), site of lesion (p = 0.034), degree of tumor differentiation (p = 0.001), and nodal metastasis (p = 0.040). Multivariate analysis using the 6 factors that were significant in univariate analysis as independent variables revealed that an air bronchogram (p = 0.010) and the degree of tumor differentiation (p = 0.008) were significant independent factors for survival.


CONCLUSIONS
The presence of an air bronchogram on HRCT may have an independent prognostic significance in lung adenocarcinoma with BAC components.
Takashima
Shodayu
S
Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan. shodayu@hsp.md.shinshu-u.ac.jp
Maruyama
Yuichiro
Y
Hasegawa
Minoru
M
Saito
Akitoshi
A
Haniuda
Masayuki
M
Kadoya
Masumi
M
D002282:Adenocarcinoma, Bronchiolo-Alveolar / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D001995:Bronchography; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D016019:Survival Analysis; D036542:Tomography, Spiral Computed