Risk factors for pathological invasiveness of non-mucinous invasive pulmonary adenocarcinoma with a maximum diameter of less than or equal to 3 cm in thin-section CT : a retrospective study

To explore the risk factors for pathological invasiveness of non-mucinous invasive lung adenocarcinoma with a maximum diameter of less than or equal to 3 cm in thin slice CT.Our study analyzed the clinical, imaging, and pathological characteristics of 700 cases of non mucinous invasive lung adenocarcinoma, and used multiple learning methods such as univariate, multivariate logistic regression, and ROC working curve to establish risk factors for pathological invasion and lymph node metastasis.The results were as follows:1.In the mixed group, multivariate logistic regression identified four independent risk factors: subtypes of cystic solid nodules, maximum lesion diameter, IASLC grading, and pathological presence of microvascular component.With an area under the ROC curve of 0.845, sensitivity of 67.8%, and specificity of 87.2%.2.In the mGNN group, multivariate logistic regression identified three independent risk factors: CTR≥0.5, IASLC grade 3, the presence of micropapillary component.With an area under the ROC curve of 0.867, sensitivity of 81.6%, and specificity of 87.8%.3.In the SN group,multivariate logistic regression identified three independent risk factors: maximum lesion diameter, IASLC grading, and the presence of micropapillary component.With an area under the ROC curve of 0.756, sensitivity of 71.9%, and specificity of 68.3%.4.In the SN group,multivariate logistic regression identified two independent risk factors for lymph node metastasis:maximum lesion diameter,vascular invasion. With an area under the ROC curve of 0.782, sensitivity of 96.6%, and specificity of 45.3%. These findings contributed to a deeper understanding of the risks associated with pathological invasiveness in non-mucinous lung adenocarcinoma with ≤ 3CM in thin-layer CT, and provided valuable insights for the development of treatment strategies.