Abstract：Objective To investigate the correlation between HRCT features and visceral pleural invasion (VPI) in lung adenocarcinoma with ground glass nodules (GGN).Methods Data of 219 patients with GGN [0≤CTR≤0.5] with diameter ≤3 cm and pathologically confirmed early lung adenocarcinoma were collected from the Fourth Medical Center of Chinese PLA General Hospital from January to December 2019. The relation between lesion and non-interlobular pleura (RLP) was divided into 5 types. Clinical and HRCT features of VPI(-) group and the VPI(+) group were analyzed by univariate analysis, and statistically significant variables were analyzed by multivariate analysis to determine the independent risk factors for predicting VPI.Results Among 219 GGNs, there were 134 cases in VPI(-) group and 85 cases in VPI(+) group. In univariate analysis, there was significant difference in the type of GGN, diameter, CT value, and RLP (P<0.05), while there was no significant difference in age, gender or location (P>0.05). The incidence of VPI in RLP types Ⅰ-Ⅲ was 0, 0, 5.6%, while the incidence of VPI in RLP types Ⅳ and Ⅴ was 45.2%, 78.7%. respectively. Multivariate analysis showed that type Ⅳ and type Ⅴ were independent risk factors for predicting VPI [P<0.001, OR=72.449, 95% confidence interval(8.743-600.333); P=0.003, OR=4.576, 95%confidence interval (1.688-12.409) ].Conclusions RLP under HRCT has a high diagnostic value for the occurrence of VPI in GGN lung adenocarcinoma. VPI does not occur in type Ⅰ and type Ⅱ, and is rare in type Ⅲ. VPI is easy to occur in type Ⅳ and type Ⅴ, which is in contact with the broad pleural base, especially the occurrence of pleural indentation sign can indicate the occurrence of VPI.
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2023, Vol. 34 
