High-Resolution CT Features: Prognostic Significance in Peripheral Lung Adenocarcinoma with Bronchioloalveolar Carcinoma Components

Abstract

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. Objectives: We studied the prognostic significance of high-resolution CT (HRCT) findings in this tumor subtype. Materials and 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. Conclusion: The presence of an air bronchogram on HRCT may have an independent prognostic significance in lung adenocarcinoma with BAC components.