Value of CT quantitative features in predicting tumor spread through air space in partially solid nodules of lung cancer

GUO Wei; HE Qingyuan; WANG Xiaohua; YUAN Huishu

doi:10.19300/j.2025.L21369

Abstract：Objective To explore the value of CT quantitative features in predicting spread through air space(STAS)in partially solid nodules of lung cancer.Methods A retrospective analysis of 80 patients with partially solid nodule lung cancer confirmed by surgical pathology,with an average age of 43.2±9.5 years.All patients underwent preoperative chest CT scans.Based on postoperative pathological results,patients were divided into STAS-positive(18 cases)and STAS-negative(62 cases)groups.The clinical data[gender,smoking history,carcinoembryonic antigen(CEA)],CT morphological features(lobulation,spiculations,pleural retraction,air bronchogram,and cyst/vacuole/cavity),and CT quantitative features(long diameter,mass,solid component ratio,and CT value of the solid part)were analyzed.Intraclass correlation coefficient(ICC)was used to assess the consistency between two physicians in evaluating CT features of partially solid nodule lung cancer.The clinical data and CT features between the two groups were compared using independent sample t-tests and chi-square tests.Receiver operating characteristic(ROC)curves were used to analyze the predicting efficacy of CT quantitative features in distinguishing STAS,and the area under the curve(AUC),sensitivity,and specificity were calculated.Results The consistency between the two physicians in evaluating CT features of partially solid nodule lung cancer was high(all ICC＞0.75).The proportion of patients with CEA＞5 ng/mL,nodule mass,and solid component ratio in the STAS-positive group were higher than in the STAS-negative group(all P＜0.05).No statistically significant differences were found between the two groups for other clinical data and CT features(all P＞0.05).The AUC,sensitivity,and specificity for predicting STAS in partially solid nodule lung cancer based on nodule mass were 0.853,72.2％,and 78.5％,respectively,which were higher than those for solid component ratio(AUC 0.775,sensitivity 66.7％,specificity 71.0％).Conclusion The solid component ratio and nodule mass in CT features have certain predictive value for STAS in partially solid nodule lung cancer,with nodule mass providing better diagnostic efficacy.