Abstract: This paper explored the evaluation value of energy spectrum CT signs and energy attenuation curve in the evaluation of the degree of lung adenocarcinoma invasion and the guiding significance for the surgical plan. Selected 110 patients with lung adenocarcinoma, and according the degree of tumor invasion diagnosed by surgical pathology the were differently divided into group A (n=62) and group B (n=48), the spectral CT examination was performed in both groups before operation. The results showed that the proportion of mixed GGN, the slope of energy decay curve (K value), the maximum diameter of nodules, and the water-based value of nodules in group B were higher than those in group A (P<0.05). K value, maximum diameter of nodules and water-based values of BAP1-positive patients were lower than those of BAP1-negative patients, and K value, maximum diameter of nodules and water-based values of Ki-67-positive patients were higher than those of Ki-67-negative patients (P＜0.05). K value, maximum diameter of nodules, and water-based values were negatively correlated with the expression of BAP1 in lung adenocarcinoma tissues, and positively correlated with the expression of Ki-67 (P<0.05). The area under the curve (AUC) for mixed GGN, K value, maximum diameter of nodules, and water-based values combined assessment of lung adenocarcinoma invasion as IAC was 0.856. It can be seen that energy spectral CT signs and energy attenuation curve have certain value in evaluating the degree of lung adenocarcinoma invasion, and have guiding significance for the selection of appropriate surgical plan before surgery.

Key words: lung adenocarcinoma, tumor invasion, energy spectrum CT, evaluation value