Growth of Residual Subsolid Nodules on Follow-up and Analysis of Influencing Factors in Patients Undergoing Lung Adenocarcinoma Resection

GAN Chongzhi; WANG Xuehai; KANG Jianhong; LIN Huahang; YU Hailiang

doi:10.3639/j.issn.2095-3097.2025.12.005

Abstract：Objective To investigate the follow-up growth of residual subsolid nodule(SSN)in patients undergoing pulmonary adenocarcinoma resection and its influencing factors.Methods A total of 156 patients who underwent lung adenocarcinoma resection at Sichuan Provincial People's Hospital from January 2019 to January 2022 and had residual SSNs after surgery were retrospectively selected.All patients were followed up postoperatively and were divided into a growth group(114 cases)and a non-growth group(42 cases)based on whether growth of the SSN of patients occurred during follow-up.General clinical data were compared between the two groups;Cox proportional hazards regression analysis was used to analyze the influencing factors for growth of residual SSNs in patients who had undergone lung adenocarcinoma resection.Results The follow-up time for residual SSNs in the 156 included patients who underwent lung adenocarcinoma resection ranged from 10 to 36 months,with a mean of(24.87±4.51)months and a median of 25 months.During follow-up,growth of residual SSNs occurred in 42 patients,with a growth rate of 26.92%.No statistically significant differences were observed between the two groups in terms of gender,body mass index,nodules in the upper lung lobe,spiculation sign,pleural indentation sign,surgical resection method,pathological type of the resected lung adenocarcinoma,or pathological stage of the resected lung adenocarcinoma(P>0.05).The growth group had higher proportions of older age,larger nodule diameter,smoking history,part-solid nodule(PSN)type,central location,vacuole sign,air bronchogram sign,and irregular/irregular-shaped nodules compared to the non-growth group(P<0.05).Multivariate Cox proportional hazards regression analysis showed that older age(HR=2.234,95%CI:1.248-3.999),larger nodule diameter(HR=2.140,95%CI:1.184-3.869),PSN type(HR=2.659,95%CI:1.536-4.603),and presence of vacuole sign(HR=2.759,95%CI:1.616-4.712)were independent risk factors for growth of residual SSNs in patients who had undergone lung adenocarcinoma resection(P<0.05).Conclusion Residual SSNs in patients undergoing pulmonary adenocarcinoma resection carry a certain risk of growth.Older age,larger nodule diameter,PSN type,and presence of vacuole sign are independent risk factors for their growth.Clinical postoperative follow-up should be strengthened for such patients.