Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules

Abstract Background Neoplastic ground glass nodules (GGNs) are relatively indolent tumors, with slow progression in invasiveness and computed tomography (CT) features. This study aimed to explore the correlation between pathological and CT characteristics and gene mutations in neoplastic GGNs. Metho...

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Main Authors: Zi-ya Zhao, Si-zhu Liu, Xue-ping Chen, Yang-li Zhang, Bin-jie Fu, Wang-jia Li, Fa-jin Lv, Zhi-gang Chu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01851-6
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author Zi-ya Zhao
Si-zhu Liu
Xue-ping Chen
Yang-li Zhang
Bin-jie Fu
Wang-jia Li
Fa-jin Lv
Zhi-gang Chu
author_facet Zi-ya Zhao
Si-zhu Liu
Xue-ping Chen
Yang-li Zhang
Bin-jie Fu
Wang-jia Li
Fa-jin Lv
Zhi-gang Chu
author_sort Zi-ya Zhao
collection DOAJ
description Abstract Background Neoplastic ground glass nodules (GGNs) are relatively indolent tumors, with slow progression in invasiveness and computed tomography (CT) features. This study aimed to explore the correlation between pathological and CT characteristics and gene mutations in neoplastic GGNs. Methods We retrospectively analyzed 1,348 neoplastic GGNs from January 2019 to November 2022, including 290 adenocarcinomas in situ (AIS), 448 microinvasive adenocarcinomas (MIA), and 610 invasive adenocarcinomas (IAC). The correlations between patients’ characteristics, pathological subtypes and grades, CT features, changes in follow-up, and gene mutations were analyzed. Results Solid component (odds ratio [OR] = 1.493; P = 0.014), larger size (OR = 1.049; P = 0.006), ill-defined boundary (OR = 1.368; P = 0.027), and lobulation sign (OR = 1.824; P = 0.001) were revealed as independent CT predictors of gene mutation. From AIS to IAC, the epidermal growth factor receptor (EGFR) mutation rate significantly increased (P < 0.01), while the kirsten rat sarcoma viral oncogene (KRAS) and the anaplastic lymphoma kinase (ALK) mutation rates significantly decreased (P < 0.05). Among IACs, mutation rate was the highest in the intermediate-grade ones (P < 0.05). Gene mutations were more frequently detected in nodules showing changes during follow-up (76.3% vs. 61.1%, P = 0.02), especially in those with more than 2-year follow-up (77.1% vs. 43.7%, P = 0.023). However, the specific changes were not associated with gene mutations (P = 0.273). Conclusions Gene mutations in neoplastic GGNs were associated with CT features, pathological subtypes and grades, and changes observed during long-term follow-up.
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spelling doaj-art-dac709b5dea448cc9b9d1a2b56c49b972025-08-20T04:02:44ZengBMCBMC Medical Imaging1471-23422025-08-0125111010.1186/s12880-025-01851-6Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodulesZi-ya Zhao0Si-zhu Liu1Xue-ping Chen2Yang-li Zhang3Bin-jie Fu4Wang-jia Li5Fa-jin Lv6Zhi-gang Chu7Department of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityThe Center for Clinical Molecular Medical detection, The First Affiliated Hospital of Chongqing Medical UniversityThe Center for Clinical Molecular Medical detection, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Neoplastic ground glass nodules (GGNs) are relatively indolent tumors, with slow progression in invasiveness and computed tomography (CT) features. This study aimed to explore the correlation between pathological and CT characteristics and gene mutations in neoplastic GGNs. Methods We retrospectively analyzed 1,348 neoplastic GGNs from January 2019 to November 2022, including 290 adenocarcinomas in situ (AIS), 448 microinvasive adenocarcinomas (MIA), and 610 invasive adenocarcinomas (IAC). The correlations between patients’ characteristics, pathological subtypes and grades, CT features, changes in follow-up, and gene mutations were analyzed. Results Solid component (odds ratio [OR] = 1.493; P = 0.014), larger size (OR = 1.049; P = 0.006), ill-defined boundary (OR = 1.368; P = 0.027), and lobulation sign (OR = 1.824; P = 0.001) were revealed as independent CT predictors of gene mutation. From AIS to IAC, the epidermal growth factor receptor (EGFR) mutation rate significantly increased (P < 0.01), while the kirsten rat sarcoma viral oncogene (KRAS) and the anaplastic lymphoma kinase (ALK) mutation rates significantly decreased (P < 0.05). Among IACs, mutation rate was the highest in the intermediate-grade ones (P < 0.05). Gene mutations were more frequently detected in nodules showing changes during follow-up (76.3% vs. 61.1%, P = 0.02), especially in those with more than 2-year follow-up (77.1% vs. 43.7%, P = 0.023). However, the specific changes were not associated with gene mutations (P = 0.273). Conclusions Gene mutations in neoplastic GGNs were associated with CT features, pathological subtypes and grades, and changes observed during long-term follow-up.https://doi.org/10.1186/s12880-025-01851-6Ground-glass opacityAdenocarcinomaComputed tomographyEpidermal growth factor receptorGene mutation
spellingShingle Zi-ya Zhao
Si-zhu Liu
Xue-ping Chen
Yang-li Zhang
Bin-jie Fu
Wang-jia Li
Fa-jin Lv
Zhi-gang Chu
Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
BMC Medical Imaging
Ground-glass opacity
Adenocarcinoma
Computed tomography
Epidermal growth factor receptor
Gene mutation
title Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
title_full Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
title_fullStr Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
title_full_unstemmed Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
title_short Exploring the relationships between CT and pathological characteristics and gene mutations in neoplastic ground glass nodules
title_sort exploring the relationships between ct and pathological characteristics and gene mutations in neoplastic ground glass nodules
topic Ground-glass opacity
Adenocarcinoma
Computed tomography
Epidermal growth factor receptor
Gene mutation
url https://doi.org/10.1186/s12880-025-01851-6
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