Value of Baseline Clinical and CT Characteristics for Predicting the Progression of Persistent Pure Ground-glass Nodule 10 mm or Less in Diameter.
Objective To explore the risk factors of the progression of persistent pure ground-glass nodule (pGGN) and make the risk stratification for pGGN 10 mm or less in diameter. Methods From June 2008 to April 2015,100 patients (108 lesions) with persistent pGGN≤10 mm in diameter were included in this study. Patients were followed up at least 1 year using thin-section computed tomography (CT). Patients' baseline clinical data and CT characteristics of pGGN were compared between progression group (size increased or/and solid component appeared) and non-progression group. Cox regression analysis was used to assess the relationship between clinical data,CT characteristics of pGGN,and lesion progression. The risk indices of lesion progression were calculated according to the results of Cox regression analysis and the relative factors of lung adenocarcinoma in previous studies. Logistic regression analysis was used to assess the relationship between risk indices and lesion progression. The optimal cutoff value was decided on receiver operating characteristic curve of risk indices and verified for predicting lesion progression. Results Fifteen of 108 lesions showed progression. The mean follow-up duration was (1016.36±486.00) days. There were statistically significant differences of lesion size,air bronchogram,and vessel changes between progression group and non-progression group (P=0.040,P=0.003,P=0.030,respectively).Lesion density (CT value≥-542.5 HU) and air bronchogram were the risk factors of lesion progression (P=0.003,P=0.021,respectively). The optimal cutoff value of total risk indices on predicting lesion progression was 4.25,with the sensitivity of 46.7%,specificity of 89.2%,and consistency of 83.3%. Conclusions CT value ≥-542.5 HU of pGGN and air bronchogram within lesion may predict lesion progression in persistent pGGN 10 mm or less in diameter. A risk index of less than 4.25 often suggests small probability of disease progression and thus a longer follow-up interval is recommended.
1. Department of Radiology,Chinese PLA General Hospital,Beijing 100853,China; 2. Department of Radiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,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.
Mei
M
Jin
Department of Radiology,Chinese PLA General Hospital,Beijing 100853,China.
Shao-Hong
SH
Zhao
D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000077192:Adenocarcinoma of Lung; D018450:Disease Progression; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed