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Minor components of micropapillary and solid subtypes in lung invasive adenocarcinoma (≤ 3 cm): PET/CT findings and correlations with lymph node metastasis

  • CHEST RADIOLOGY
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Abstract

Objective

To investigate the PET/CT findings in lung invasive adenocarcinoma with minor components of micropapillary or solid contents and its association with lymph node metastasis.

Materials and methods

A total of 506 lung invasive adenocarcinoma (≤ 3 cm) patients who underwent a PET/CT examination and resection surgery were included. According to the proportion of solid/micropapillary components, the patients were classified into three groups: solid/micropapillary-negative (SMPN) (n = 258), solid/micropapillary-minor (SMPM; > 5% not predominant) (n = 158) and solid/micropapillary-predominant (SMPP; > 5% most dominant) (n = 90). The patients’ PET/CT findings, including SUVmax, MTV, TLG and CT characteristics, and other clinical factors were compared by one-way ANOVA test. Logistic regression analysis was done to identify the most predictive findings for lymph node metastasis.

Results

The value of SUVmax, MTV, TLG and tumor size was highest in SMPP group, followed by SMPM and SMPN group (P < 0.001).The areas under the curve for SUVmax, MTV and TLG for node metastasis were 0.822, 0.843 and 0.835, respectively. Univariate analysis found that the SMPP and SMPM group had more lymph node metastasis than the SMPN group (P < 0.001). Furthermore, the lymph node metastasis group had higher CEA, SUVmax, MTV, TLG, tumor size and more pleural invasion (P < 0.001). Logistic regression analysis found that SMPP pathological type, SMPM pathological type, higher CEA and male patients were risk factors for lymph node metastasis (P < 0.01).

Conclusions

Lung invasive adenocarcinoma with micropapillary or solid contents had higher SUVmax, MTV, TLG and tumor size and was associated with lymph node metastasis, even if they were not predominant.

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Acknowledgements

This study was supported by the Natural Science Foundation of Shanghai (Grant Number 18ZR1435200); the National Natural Science Foundation of China (Grant Number 81602415); and the Scientific Research project of Shanghai Municipal Commission of Health and Family Planning (Grant Number 20174Y0077); the National Natural Science Foundation of China (Grant NUMBERS 81773007).

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Authors and Affiliations

  1. Department of Radiology, Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Gusu District, Suzhou, 215000, Jiangsu, China

    Cheng Chang, Wenlu Zhao & Junkang Shen

  2. Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Road, Shanghai, 200030, China

    Cheng Chang, Xiaoyan Sun, Bei Lei, Lihua Wang, Liu Liu, Maomei Ruan & Wenhui Xie

  3. Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Road, Shanghai, 200030, China

    Rui Wang

  4. Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China

    Xiaohua Qian

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  1. Cheng Chang
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Correspondence to Wenhui Xie or Junkang Shen.

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The institutional ethics review board approved this retrospective study and waived the need for informed consent.

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Chang, C., Sun, X., Zhao, W. et al. Minor components of micropapillary and solid subtypes in lung invasive adenocarcinoma (≤ 3 cm): PET/CT findings and correlations with lymph node metastasis. Radiol med 125, 257–264 (2020). https://doi.org/10.1007/s11547-019-01112-x

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