Objective To investigate the diagnostic value of morphological parameters of thin-layer CT of the chest for visceral pleural invasion(VPI)of nodular lung adenocarcinoma.Methods 202 patients with lung adenocarcinoma who underwent preoperative thin-layer CT scanning of the chest and radical lung cancer surgery were selected and divided into the VPI group(n=71)and the non-VPI group(n=131)according to pathological results.The clinical data,pathological contents and imaging characteristics of the patients were analysed,and SPSS 25.0 software was applied for statistical analy-sis.Results In univariate analysis,smoking history,CEA,pathological type,Ki-67,degree of differentiation,nature of the nodule,maximum longitudinal diameter of the lesion,maximum shortitudinal diameter of the lesion,mean CT value,burr sign,relationship between the nodule and the pleura,shortest distance of the lesion from the neighbouring pleura,diameter of the contact between the lesion and pleura,and the pleural contact ratio showed statistically significant differences between the VPI and non-VPI groups.Multifactorial Logistic regression analysis showed nodal-to-pleural relationship type 4(OR=30.071,95％CI:3.146-287.459),pleural contact ratio(OR=9.584,95％CI:1.152-79.749),and CEA abnormality(OR=2.989,95％CI:1.090-8.197),degree of differentiation(OR=13.230,95％CI:3.239-54.036)were inde-pendent influencing factors for the diagnosis of nodular lung adenocarcinoma VPI(P＜0.05);the ROC curve showed that the optimal cut-off point of pleural contact ratio was 0.029167,with an AUC of 0.703(95％CI:0.625-0.782),a sensi-tivity of 63.4％and a specificity was 75.6％.Conclusion Predictors of VPI in patients with nodular lung adenocarcino-ma were nodal-to-pleural relationship type 4,pleural contact ratio,CEA abnormality and poor differentiation.
Thin slice CT of chestAdenocarcinoma of the lungVisceral pleural invasion
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