Abstract:Objective: To explore the relationship between CT signs and differentiation degree and lymph node metastasis of ground-glass nodular multifocal lung adenocarcinoma (MLA). Methods: The clinical data of 156 patients with MLA treated in the hospital between January 2016 and July 2021 were retrospectively analyzed. Patients were grouped according to the differentiation degree and lymph node metastasis into high differentiation subgroup (n=48), moderate differentiation subgroup (n=65), low differentiation subgroup (n=43), metastasis subgroup (n=81) and non-metastasis subgroup (n=75). The differences in CT signs were compared among patients with MLA of different differentiation degrees and metastasis status, and spearman correlation analysis was used to explore the relationship between CT signs and differentiation degree and lymph node metastasis. Results: The occurrence rate of lesions≥3cm in high differentiation subgroup was lower than that in low differentiation subgroup. The occurrence rate of pGGN in high differentiation subgroup was higher than that in moderate and low differentiation subgroups. The occurrence rates of spicule sign, lobulation sign, cavitation sign, vascular convergence sign and pleural indentation in high differentiation subgroup were lower than those in low differentiation subgroup. The occurrence rate of vascular convergence sign in moderate differentiation subgroup was lower than that in low differentiation subgroup (all P<0.05). According to spearman correlation analysis, the length of the lesion in patients with MLA was negatively correlated with the differentiation degree (r=-0.337, P<0.05). There were significant differences in the length of the lesion≥3cm and occurrence rates of round or round-like shape, lobulation sign and vascular convergence sign between metastasis subgroup and non-metastasis subgroup (all P<0.05), but there were no statistical differences in the occurrence rates of pGGN, spicule sign, cavitation sign and pleural indentation between the two subgroups (all P>0.05). By spearman correlation analysis, the length of the lesion in patients with MLA was related to lymph node metastasis (r=0.429, P<0.05). Conclusion: The length of the lesion and occurrence rates of pGGN, spicule sign, lobulation sign, cavitation sign, vascular convergence sign and pleural indentation are related to the degree of differentiation. The length of the lesion and occurrence rates of round or round-like shape, lobulation sign and vascular convergence sign are related to lymph node metastasis. According to some CT signs of patients with MLA, differentiation degree and lymph node metastasis can be preliminarily judged.