title: Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography.
abstract: BACKGROUND
  Lung nodules are being detected at an increasing rate year by year with high-resolution computed tomography (HRCT) being widely used. Ground-glass opacity nodule is one of the special types of pulmonary nodules that is confirmed to be closely associated with early stage of lung cancer. Very little is known about solitary ground-glass opacity nodules (SGGNs). In this study, we analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT.
  
  
  METHODS
  A total of 95 resected SGGNs were evaluated with HRCT scan. The clinical, pathological, and radiological characteristics of these cases were analyzed.
  
  
  RESULTS
  Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarcinoma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (allP<0.05).
  
  
  CONCLUSIONS
  We analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT and found that the size, density, shape, and pleural tag of SGGNs on HRCT are found to be the determinant factors of IA. In conclusion, detection of anaplastic lymphoma kinase expression and performance of PET/CT scan are not routinely recommended.
authors.affiliation: Department of Respiratory Medicine.
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Qiu
authors.affiliation: Department of Respiratory Medicine.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Respiratory Medicine.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Wei-Ya
authors.initials: WY
authors.lastname: Wang
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Xia
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Wei-Lu
authors.initials: WL
authors.lastname: Wu
authors.affiliation: Department of Respiratory Medicine; Department of Pathology, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Li
keywords: HRCT; SGGNs; adenocarcinoma; clinical; pathological