Correlations between pathologic subtypes/immunohistochemical implication and CT characteristics of lung adenocarcinoma ≤ 1 cm with ground-glass opacity.
OBJECTIVE
To discuss the correlation of pathologic subtypes and immunohistochemical implication with CT features of lung adenocarcinoma 1 cm or less in diameter with focal ground-glass opacity (fGGO).


METHODS
CT appearances of 59 patients who underwent curative resection of lung adenocarcinoma ≤ 1 cm with fGGO were analyzed in terms of lesion location, size, density, shape (round, oval, polygonal, irregular), margin (smooth, lobular, spiculated, lobular and spiculated), bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface. Histopathologic subtypes were classified according to International Association for the Study of Lung Cancer/ American Thoracic Society/European Respiratory Society classification of lung adenocarcinoma. Common molecular markers in immunohistochemical study included human epidermal growth factor receptor (HER)-1,HER-2,Ki-67, vascular endothelial growth factor (VEGF) and DNA topoisomerase 2Α.Patients' age and lesions' size and density were compared with pathologic subtypes using analysis of variance or nonparametric Wilcoxon tests. Patients' gender, lesion location, shape and margin, bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface were compared with histopathologic subtypes and immunohistochemical implication using ψ² test or Fisher's exact test.


RESULTS
The patients' gender, age, lesion location, shape, air bronchogram, pleural tag, and tumor-lung interface were not significantly different among different histopathologic subtypes (P=0.194, 0.126, 0.609, 0.678, 0.091, 0.374, and 0.339, respectively), whereas the lesion size,density,bubble-like sign, and margin showed significant differences (P=0.028, 0.002, 0.003, 0.046, respectively). The expression of Ki-67 significantly differed among nodules with different shapes(P=0.015). Statistically significant difference also existed between tumor-lung interface and HER-1 expression (P=0.019) and between bubble sign and HER-2 expression (P=0.049).


CONCLUSIONS
Of lung adenocarcinoma ≤ 1 cm with fGGO,bubble-like sign occurs more frequently in invasive pulmonary adenocarcinoma and less frequently in atypical adenomatous hyperplasia. In addition, preinvasive lesions (atypical adenomatous hyperplasia and adenocarcinoma in situ) more frequently demonstrates smooth margin,while invasive lesions (minimally invasive adenocarcinoma and invasive pulmonary adenocarcinoma) more frequently demonstrates lobular and spiculated margin. Some CT features are associated with immunohistochemical implication of lung adenocarcinoma ≤ 1 cm with fGGO.
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Fang
F
Wu
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Zu-long
ZL
Cai
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Shu-ping
SP
Tian
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Xin
X
Jin
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Rui
R
Jing
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Yue-qing
YQ
Yang
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Ying-na
YN
Li
Department of Radiology, Chinese PLA General Hospital, Beijing 100853, China.
Shao-hong
SH
Zhao
D000230:Adenocarcinoma; D000077192:Adenocarcinoma of Lung; D006801:Humans; D006965:Hyperplasia; D008168:Lung; D008175:Lung Neoplasms; D042461:Vascular Endothelial Growth Factor A
C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A