Growth characteristics of early-stage (IA) lung adenocarcinoma and its value in predicting lymph node metastasis

• Published in: Cancer imaging 2023-12, Vol.23 (1), p.115-115, Article 115
• Main Authors: Liu, Mengxi, Mu, Junhao, Song, Feipeng, Liu, Xiangling, Jing, Weiwei, Lv, Fajin
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma of Lung - pathology; Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; Dissection; Humans; Lung adenocarcinoma; Lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - pathology; Lymph node (LN) Metastasis; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Lymphatic system; Mass doubling time (MDT); Medical screening; Metastasis; Neoplasm Staging; Nodules; Pathology; Patients; Retrospective Studies; Solitary pulmonary nodule (SPN); Surgery; Tomography, X-Ray Computed - methods; Volume doubling time (VDT); Work stations
• ISSN: 1470-7330; 1740-5025; 1470-7330
• DOI: 10.1186/s40644-023-00631-1

We aim to compare the differences in growth characteristics between part-solid and solid lung adenocarcinoma, and to investigate the value of volume doubling time (VDT) or mass doubling time (MDT) in predicting lymph node (LN) metastasis and preoperative evaluation in patients of early-stage (IA) non-small cell lung cancer (NSCLC). We reviewed 8,653 cases of surgically resected stage IA lung adenocarcinoma between 2018 and 2022, with two follow-up visits at least 3 months apart, comparing diameter, volume, and mass growth of pSN and SN. VDT and MDT calculations for nodules with a volume change of at least 25%. Univariable or multivariable analysis was used to identify the risk factors. The area under the curve (AUC) for the receiver operating characteristic (ROC) curves was used to evaluate the diagnostic value. A total of 144 patients were included 114 with solid nodules (SN) and 25 with part-solid nodules (pSN). During the follow-up period, the mean VDTt and MDTt of SN were shorter than those of pSN, 337 vs. 541 days (p = 0.005), 298 vs. 458 days (p = 0.018), respectively. Without considering the ground-glass component, the mean VDTc and MDTc of SN were shorter than the solid component of pSN, 337 vs. 498 days (p = 0.004) and 298 vs. 453 days (p = 0.003), respectively. 27 nodules were clinically and pathologically diagnosed as N1/N2. Logistic regression identified initial diameter (p