To explore the morphological features of precursor glandular lesions and inflammatory nodules based on high resolution computed tomography (HRCT) to improve the accuracy of imaging diagnosis.

This study is a case-control study.The non-random sampling method was used.Patients with precursor glandular lesions (n=50) including atypical adenomatous hyperplasia and adenocarcinoma in situ and inflammatory nodules (n=50), which were confirmed by operation pathology in Huizhou Central People′s Hospital from January 2020 to June 2022, were enrolled for analysis.The clinical data and morphological features of pulmonary nodules were compared to screen out variables with statistical differences.According to the binary logistic regression analysis, independent risk factors were screened out to establish a joint model for differential diagnosis, and receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance.

The precursor glandular lesions group had smaller nodule diameter, mostly located in the upper lungs, with regular morphology and mostly subsolid nodules as compared with the inflammatory nodules group (all P<0.05). The logistic regression analysis showed that nodule size and nodule type were independent risk factors for precursor glandular lesions.ROC curve analysis showed that when the optimal cut-off value of nodule diameter was 7 mm, the area under the curve (AUC) was 0.946 (95% CI: 0.882-0.981), the sensitivity for 92%, and the specificity for 84%.

HRCT-based morphological differences contribute to differential diagnosis for precursor glandular lesions and inflammatory nodules.Subsolid nodules and size <7 mm are more prone to glandular precursor lesions, which provides a reference for the selection of clinical treatment methods.

Adenoma; Carcinoma in situ; Solitary pulmonary nodule; Diagnosis, differential; Regression analysis