A Multidimensional CT-Based Tumor Location Metric for Predicting Lymph Node Metastasis and Occult Lymph Node Metastasis in Lung Adenocarcinoma
4 affiliations
- 1Department of Thoracic Surgery, Daping Hospital, Army Medical University, Chongqing, P.R. China
- 2Department of Pathology, Daping Hospital, Army Medical University, Chongqing, P.R. China
- 3Department of Information, Daping Hospital, Army Medical University, Chongqing, P.R. China
- 4College of Computer Science, Chongqing University, Chongqing, P.R. China
Abstract
Introduction: Lymph node (LN) metastasis of lung adenocarcinoma, particularly occult lymph node metastasis (OLNM), remains difficult to predict using conventional imaging and basic positional parameters, adversely affecting prognosis. This study aimed to: (1) evaluate a new CT index (a/A + b/B) for predicting OLNM in cN0 patients, and (2) create and validate a nomogram for predicting LN metastasis probability in CT-suspected cases.
Methods: This single-center retrospective study involved 387 lung adenocarcinoma patients (225 non-LN, 84 OLNM, and 78 with CT-suspected/pathologically confirmed LN metastasis) who had surgery from 2016 to 2024. A spatial index (a/A + b/B) was developed to combine two perpendicular anatomical axes, vertical proximity to the interlobar fissure and horizontal proximity to the mediastinum/hilum, into one standardized metric.
Results: The combined ratio a/A + b/B was significantly lower in the OLNM and metastatic groups. A lower a/A + b/B was significantly associated with OLNM (OR = 0.175, 95% CI: 0.048–0.638, P = 0.007), suggesting a 0.1-unit decrease in the a/A + b/B ratio increased OLNM risk by 19%. A nomogram utilizing a/A + b/B differentiates CT-suspected LN metastasis from node-negative cases, showing AUCs of 0.83 (95% CI: 0.76–0.90) in training, 0.85(95% CI: 0.76–0.94) in internal validation, and 0.70(95% CI: 0.50–0.91) in external validation.
Conclusion: A ratio of a/A + b/B < 0.6 indicates a high OLNM risk in cN0 patients. This index can predict OLNM when LNs are small on CT, and a nomogram can differentiate CT-suspected LN metastasis from node-negative cases, meriting further study.
Related
- Development and internal validation of a clinical-MRI nomogram for predicting lymph node metastasis in rectal adenocarcinoma.
- MR radiomics for predicting lymph node metastasis of pancreatic ductal adenocarcinoma by comparing different contrast-enhanced phases
- Anatomical location matters: risk modelling and surgical outcomes in central lymph node metastasis of isthmus PTC
- Machine learning-based prediction of lymph node metastasis in papillary thyroid carcinoma: an interpretable multidimensional model
- Leptomeningeal metastasis of lung adenocarcinoma presenting as cauda equina syndrome: a case report and literature review
BibTeX
@article{wu2026multidimensional,
title = {{A Multidimensional CT-Based Tumor Location Metric for Predicting Lymph Node Metastasis and Occult Lymph Node Metastasis in Lung Adenocarcinoma}},
author = {Licheng Wu and Haoran Shang and Chengyi Mao and Zhi Wei and Fuqiang Dai and Longyong Mei and Yonggeng Feng and Zhipeng Hao and Jingge Zhang and Dongdong Wu and Yi Wang and Bo Deng},
journal = {Technology in Cancer Research \& Treatment},
year = {2026},
month = oct,
doi = {10.1177/15330338261494765},
url = {https://doi.org/10.1177/15330338261494765},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A Multidimensional CT-Based Tumor Location Metric for Predicting Lymph Node Metastasis and Occult Lymph Node Metastasis in Lung Adenocarcinoma
AU - Licheng Wu
AU - Haoran Shang
AU - Chengyi Mao
AU - Zhi Wei
AU - Fuqiang Dai
AU - Longyong Mei
AU - Yonggeng Feng
AU - Zhipeng Hao
AU - Jingge Zhang
AU - Dongdong Wu
AU - Yi Wang
AU - Bo Deng
PY - 2026
DA - 2026/10/01
JO - Technology in Cancer Research & Treatment
DO - 10.1177/15330338261494765
UR - https://doi.org/10.1177/15330338261494765
AB - Introduction: Lymph node (LN) metastasis of lung adenocarcinoma, particularly occult lymph node metastasis (OLNM), remains difficult to predict using conventional imaging and basic positional parameters, adversely affecting prognosis. This study aimed to: (1) evaluate a new CT index (a/A + b/B) for predicting OLNM in cN0 patients, and (2) create and validate a nomogram for predicting LN metastasis probability in CT-suspected cases. Methods: This single-center retrospective study involved 387 lung adenocarcinoma patients (225 non-LN, 84 OLNM, and 78 with CT-suspected/pathologically confirmed LN metastasis) who had surgery from 2016 to 2024. A spatial index (a/A + b/B) was developed to combine two perpendicular anatomical axes, vertical proximity to the interlobar fissure and horizontal proximity to the mediastinum/hilum, into one standardized metric. Results: The combined ratio a/A + b/B was significantly lower in the OLNM and metastatic groups. A lower a/A + b/B was significantly associated with OLNM (OR = 0.175, 95% CI: 0.048–0.638, P = 0.007), suggesting a 0.1-unit decrease in the a/A + b/B ratio increased OLNM risk by 19%. A nomogram utilizing a/A + b/B differentiates CT-suspected LN metastasis from node-negative cases, showing AUCs of 0.83 (95% CI: 0.76–0.90) in training, 0.85(95% CI: 0.76–0.94) in internal validation, and 0.70(95% CI: 0.50–0.91) in external validation. Conclusion: A ratio of a/A + b/B < 0.6 indicates a high OLNM risk in cN0 patients. This index can predict OLNM when LNs are small on CT, and a nomogram can differentiate CT-suspected LN metastasis from node-negative cases, meriting further study.
SN - 1533-0346
SN - 1533-0338
ER -