| Summary: | Objective Objective To investigate the differences of clinicopathological characteristics and CT features in different histology subtypes of invasive lung adenocarcinoma (ILA), and to find a noninvasive imaging method that can help to distinguish them. Methods A total of 422 patients confirmed with solitary ILA by surgical resection in our hospital from July 2013 to July 2019 were included. All patients were divided into group A (those with a lepidic/acinar/papillary predominant pattern) and group B (those with a solid/micropapillary predominant pattern) according to the main pathological growth pattern. Moreover, group A was divided into group A1 (those with a lepidic predominant pattern) and group A2 (those with an acinar / papillary predominant pattern). The clinicopathology and CT features between group A and group B as well as those between group A1 and group A2 were compared, respectively. Results 1Comparison of clinicopathological characteristics between group A and B: Gender and smoking history of patients, as well as histologic differentiation, lymph node metastasis status and pathologic TNM stage of tumors significantly differed between the two groups (all P < 0.05). Patients with male and smoking, tumors with poor histology differentiation, lymph node metastasis, and pathologic TNM stage of III-IV were more frequently seen in group B. However, no significant difference in the distant metastasis was observed between the two groups (P > 0.05). 2Comparison of CT features between group A and B: Lesion size, density, vascular convergence sign, air bronchogram, calcification, necrosis and pleural effusion were associated with the histological subtypes (all P < 0.05). Tumors in Group B were significantly larger than those in Group A. In addition, tumors with solid density, calcification, necrosis and pleural effusion were more frequently observed in Group B, whereas those with vascular convergence sign and air bronchogram were more common in Group A. However, no significant associations were found between other CT features and histological subtypes, including the distribution of tumors, air space, speculation, lobulation, and pleural retraction (all P > 0.05). 3Comparison of clinicopathological characteristics and CT features between group A1 and A2: Tumors with subsolid density were more common in Group A1, while those with solid density were more common in Group A2 (P < 0.001). However, no significant differences were found in other clinicopathological characteristics and CT features between the two groups (all P > 0.05). Conclusion For clinicopathological characteristics, male, smoking, poor histology differentiation, lymph node metastasis, and pathologic TNM stage of III-IV were more common in patients with a solid/micropapillary predominant pattern. For CT features, tumors with large size, solid density, calcification, necrosis and pleural effusion were more common in patients with a solid/micropapillary predominant pattern, whereas those with vascular convergence sign and air bronchogram were more common in patients with a lepidic/acinar/papillary predominant pattern.
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