Abstract
Background More effective methods are urgently needed for predicting the pathological grade
and lymph node metastasis of cT1-stage lung adenocarcinoma.
Methods We analyzed the relationships between CT quantitative parameters (including three-dimensional
parameters) and pathological grade and lymph node metastasis in cT1-stage lung adenocarcinoma
patients of our center between January 2015 and December 2023.
Results A total of 343 patients were included, of which there were 233 males and 110 females,
aged 61.8 ± 9.4 (30–82) years. The area under the receiver operating characteristic
(ROC) curve for predicting the pathological grade of lung adenocarcinoma using the
consolidation–tumor ratio (CTR) and the solid volume ratio (SVR) were 0.761 and 0.777,
respectively. The areas under the ROC curves (AUCs) for predicting lymph node metastasis
were 0.804 and 0.873, respectively. Multivariate logistic regression analysis suggested
that the SVR was an independent predictor of highly malignant lung adenocarcinoma
pathology, while the SVR and pathological grade were independent predictors of lymph
node metastasis. The sensitivity of predicting the pathological grading of lung adenocarcinoma
based on SVR >5% was 97.2%, with a negative predictive value of 96%. The sensitivity
of predicting lymph node metastasis based on SVR >47.1% was 97.3%, and the negative
predictive value was 99.5%.
Conclusion The SVR has greater diagnostic value than the CTR in the preoperative prediction
of pathologic grade and lymph node metastasis in stage cT1-stage lung adenocarcinoma
patients, and the SVR may replace the diameter and CTR as better criteria for guiding
surgical implementation.
Keywords
lung adenocarcinoma - predictive factor - lymph node metastasis - pathological grading
