Prognostic Nomograms Based on Ground Glass Opacity and Subtype of Lung Adenocarcinoma for Patients with Pathological Stage IA Lung Adenocarcinoma

Abstract

The value of lung adenocarcinoma (LUAD) subtypes and ground glass opacity (GGO) in pathological stage IA invasive adenocarcinoma (IAC) has been poorly understood, and reports of their association with each other have been limited. In the current study, we retrospectively reviewed 484 patients with pathological stage IA invasive adenocarcinoma (IAC) at Sun Yat-sen University Cancer Center from March 2011 to August 2018. Patients with at least 5% solid or micropapillary presence were categorized as high-risk subtypes. Independent indicators for disease-free survival (DFS) and overall survival (OS) were identified by multivariate Cox regression analysis. Based on these indicators, we developed prognostic nomograms of OS and DFS. The predictive performance of the two nomograms were assessed by calibration plots. A total of 412 patients were recognized as having the low-risk subtype, and 359 patients had a GGO. Patients with the low-risk subtype had a high rate of GGO nodules (p < 0.001). Multivariate Cox regression analysis showed that the high-risk subtype and GGO components were independent prognostic factors for OS (LUAD subtype: p = 0.002; HR 3.624; 95% CI 1.263–10.397; GGO component: p = 0.001; HR 3.186; 95% CI 1.155–8.792) and DFS (LUAD subtype: p = 0.001; HR 2.284; 95% CI 1.448–5.509; GGO component: p = 0.003; HR 1.877; 95% CI 1.013–3.476). The C-indices of the nomogram based on the LUAD subtype and GGO components to predict OS and DFS were 0.866 (95% CI 0.841–0.891) and 0.667 (95% CI 0.586–0.748), respectively. Therefore, the high-risk subtype and GGO components were potential prognostic biomarkers for patients with stage IA IAC, and prognostic models based on these indicators showed good predictive performance and satisfactory agreement between observational and predicted survival.

A combination of radiomic features, clinic characteristics, and serum tumor biomarkers to predict the possibility of the micropapillary/solid component of lung adenocarcinoma

“…The consolidation-to-tumor ratio (CTR) was calculated as the ratio of the solid tumor size over the tumor size. 21 When the value of CTR is lower, it indicates that the lesion contains a higher proportion of ground-glass opacity components. The closer the value of CTR is to 1, the more the lesion tends toward consolidation.…”

Micropapillary or solid component predicts worse prognosis in pathological IA stage lung adenocarcinoma: A meta-analysis

“…The Medline, EMBASE, Web of Science and CNKI electronic databases were searched from inception to December 31, 2022. The following key words were used during the search: lung, Sumiyoshi [24] 2013 Japan 256 >5% -MIP+ DFS, OS E Hirano [25] 2014 Japan 218 >5% -MIP+ OS E Luo [26] 2017 China 2504 -Predominant SD+ DFS, OS R Wang [27] 2018 China 1965 >5% >5% MIP+/SD+ DFS, OS R Chen C [28] 2020 China 77 >5% >5% MIP+, SD+ OS E Chen D [29] 2020 China 1543 Predominant -MIP+ DFS, OS E Chen D [29] 2020 China 714 Predominant -MIP+ DFS, OS E Zhang [30] 2020 China 90 Predominant Predominant MIP+/SD+ OS R Peng [31] 2021 China 422 >5% >5% MIP+/SD+, MIP+, SD+ DFS, OS R/E Choi [33] 2021 Korea 299 0-5% 0-5% MIP+/SD+ DFS R Jeon [34] 2021 Republic of Korea 429 >20% >20% MIP+/SD+ DFS, OS R Zhai [35] 2021 China 484 >5% >5% MIP+/SD+ DFS, OS R Chen Y [32] 2021 China 314 >5% >5% MIP+, SD+ DFS, OS R Zhang [36] 2021 China 435 --MIP+, SD+ DFS, OS R Bertoglio [37] 2022 Italy 326 >5% >5% MIP+/SD+ DFS, OS E Chen C [38] 2022 China 814 >1% >1% MIP+, SD+ DFS R Huang [39] 2022 China 595 >10% >10% MIP+/SD+ DFS, OS R Jin [40] 2022 China 321 >5% >5% MIP+/SD+ DFS R Okubo [42] 2022 Japan 380 Predominant Predominant MIP+, SD+ DFS R Lu [41] 2022 China 306 --MIP+/SD+ DFS, OS R DFS = disease-free survival, E = estimated, HR = hazard ratio, MIP = micropapillary, NOS = Newcastle-Ottawa Scale, NR = not reported, OS = overall survival, R = reported, SD = solid.…”

“…A total of 19 studies were eventually included in this meta-analysis. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]…”

Evaluation of Prognosis in Patients with Lung Adenocarcinoma with Atypical Solid Nodules on Thin-Section CT Images

“…A ground-glass opacity component in lung adenocarcinoma indicates a favorable prognosis. Even in patients with stage IA1 lung cancer with the highest survival rate, the size of the solid component and ground-glass opacity significantly affect prognosis ( 6 – 9 ). This may be because ground-glass opacity correlates with the lepidic component, and the solid component correlates with the invasive component ( 6 , 10 , 11 ).…”