CHEST RADIOLOGY / ORIGINAL PAPER
Analysis of risk factors for early detection of cystic lung cancer based on CT genomics and its relationship with pathological invasion
1
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, P.R. China
2
Jiangxi Provincial Key Laboratory of Respiratory Diseases, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, P.R. China
3
Jiangxi Institute of Respiratory Disease, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, P.R. China
4
Jiangxi Hospital of China-Japan Friendship Hospital, National Regional Centre for Respiratory Medicine, Nanchang, P.R. China
5
Department of Ultrasonography, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, P.R. China
These authors had equal contribution to this work
Submission date: 2025-07-22
Acceptance date: 2025-08-18
Publication date: 2025-11-18
Pol J Radiol, 2025; 90: 551-560
KEYWORDS
TOPICS
ABSTRACT
Purpose:
This study aims to compare the clinical, imaging, and pathological characteristics of benign and malignant solitary pulmonary cystic nodules, and identify key indicators associated with malignant risk and invasion depth, assisting clinicians in early detection and assessment of tumour invasiveness.
Material and methods:
This study conducted a retrospective analysis of patients with pulmonary cystic nodules who underwent surgical treatment, and it classified them into benign and malignant groups based on postoperative pathological results. We collected patients’ clinical data, serum biomarkers, and CT imaging data and compared them using univariate analysis of variance. We included statistically significant indicators in a multivariate regression model to identify independent predictive factors for early malignant transformation of cystic lung cancer. Additionally, we collected the pathological types and tissue infiltration grades of the malignant group and further explored the relationship between imaging features and pathological grading by comparing the imaging characteristics corresponding to different pathological infiltration degrees, and visualised the results using a forest plot.
Results:
Following multifactorial Cox analysis age, CA199, homogeneity of cyst wall thickness, cystic wall finish, number of cystic cavities, ground glass sign, and the nodule’s relationship to surrounding tissues (burr, pleural indentation sign) had a significant effect on the evolution of cystic malignant nodules. Finally, in the malignant nodule group, the presence or absence of the ground glass sign was statistically significant concerning the different pathologic grades.
Conclusions:
Our multivariate predictive study indicates that certain imaging features of pulmonary cystic nodules may suggest malignant progression and are associated with different levels of pathological invasion.
This study aims to compare the clinical, imaging, and pathological characteristics of benign and malignant solitary pulmonary cystic nodules, and identify key indicators associated with malignant risk and invasion depth, assisting clinicians in early detection and assessment of tumour invasiveness.
Material and methods:
This study conducted a retrospective analysis of patients with pulmonary cystic nodules who underwent surgical treatment, and it classified them into benign and malignant groups based on postoperative pathological results. We collected patients’ clinical data, serum biomarkers, and CT imaging data and compared them using univariate analysis of variance. We included statistically significant indicators in a multivariate regression model to identify independent predictive factors for early malignant transformation of cystic lung cancer. Additionally, we collected the pathological types and tissue infiltration grades of the malignant group and further explored the relationship between imaging features and pathological grading by comparing the imaging characteristics corresponding to different pathological infiltration degrees, and visualised the results using a forest plot.
Results:
Following multifactorial Cox analysis age, CA199, homogeneity of cyst wall thickness, cystic wall finish, number of cystic cavities, ground glass sign, and the nodule’s relationship to surrounding tissues (burr, pleural indentation sign) had a significant effect on the evolution of cystic malignant nodules. Finally, in the malignant nodule group, the presence or absence of the ground glass sign was statistically significant concerning the different pathologic grades.
Conclusions:
Our multivariate predictive study indicates that certain imaging features of pulmonary cystic nodules may suggest malignant progression and are associated with different levels of pathological invasion.
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