Study on the clinical and imaging features of solitary pulmonary glass nodule

Abstract

Objective To investigate the imaging features of the elderly patients with GGN and to guide the follow-up. Methods Thirty-four cases of elderly patients with pulmonary GGN were enrolled in this study, including 14 cases of adenocarcinoma in situ (AIS) and 20 cases of invasive adenocarcinoma (IAC). The clinical characteristics of these patients were analyzed and compared.The CT imaging features of burr sign, lobulated sign, pleural retraction sign, vacuole sign and solid component were analyzed by two doctors via blind method.The average diameter, volume, mass, volume doubling time (VDT) and mass doubling time (MDT) of GGN were measured and calculated by software layer by layer overlay model. Results There were no statistically significant differences between the group AIS and group IAC in age, gender, smoking history (P>0.05); The burr sign, lobulated sign, vacuole sign, pleural retraction sign and the average diameter had no significant difference (P>0.05). There were statistically significant difference between the group AIS and group IAC in the solid component incidence (14.3%, 65%, P=0.003), volume ( (714.4+ 261.8) mm3, (927.2±259.7) mm3, t=2.344, P=0.025), mass ( (376.4±144.0) mg, (586.8±182.0) mg, t=3.600, P=0.001), volume doubling time ( (1511.1±1098.2) d, (654.1±229.0) d, t=-2.876, P=0.012), quality doubling time ( (1427.4±989.3) d, (540.4±190.7) d, t=-3.312, P=0.005). Conclusion The signs of solid components, volume, mass, VDT, MDT can be used as an important basis for identification of AIS and GGN in the elderly patients.The treatment of the elderly patients with GGN should be based on the basic diseases, life expectancy, surgical risk and imaging features of the elderly patients, so as to give more appropriate treatment strategies for the elderly patients. Key words: Lung cancer; Ground-glass nodule; Elderly; Volume; Mass; Doubling time