目的:探讨三维CT定量联合定性参数logistic回归模型对纯磨玻璃结节（pGGN）侵袭性的预测价值。方法:回顾性分析安徽省胸科医院2019年4月至2019年12月经手术病理证实为肺腺癌且三维CT表现为pGGN的191例患者（196个病灶）的临床及影像资料。196个病灶根据病理结果分为不典型腺瘤样增生（AAH）+原位腺癌（AIS）+微浸润腺癌（MIA）组（n n=128）和浸润性腺癌（IAC）组（n n=68）。CT评价的定量参数包括结节最长径、结节体积、平均CT值及质量，定性参数包括血管异常征、空气支气管异常征、分叶征、空泡征、胸膜牵拉征、瘤肺界面模糊征。两组间定量参数比较采用Mann-Whitney U检验，定性参数的比较采用χ2检验。采用单因素结合多因素logistic回归模型筛选IAC组的独立预测因子及预测概率值，通过ROC曲线比较logistic回归模型的预测概率值与各单因素参数预测IAC的效能。n 结果:AAH+AIS+MIA和IAC组间结节最长径分别为0.92（0.77，1.14）、1.41（1.12，1.93）cm（n Z=-7.366，n P<0.001），结节体积分别为0.31（0.20，0.53）、0.88（0.41，2.00）cmn 3（n Z=-6.254，n P<0.001），结节平均CT值分别为-571.5（-637.2，-477.0）、-418.1（-532.4，-338.5）HU（n Z=-5.882，n P<0.001），结节质量分别为0.14（0.09，0.25）、0.42（0.26.1.21）g（n Z=-7.438，n P<0.001），血管异常征分别为23、49个（χ2=55.906，n P<0.001），空气支气管异常征分别为13、30个（χ2=29.908，n P<0.001），胸膜牵拉征分别为39、32个（χ2=5.291，n P=0.021）。logistic回归结果显示结节最长径、结节平均CT值、血管异常征及空气支气管异常征是IAC的独立预测因子，其优势比（95%CI）分别为10.624（1.275~88.522）、1.004（1.000~1.008）、3.424（1.458~8.043）、2.993（1.114~8.043）。ROC曲线结果显示logistic回归模型曲线下面积为0.899，灵敏度为0.912，特异度为0.711， 结果均优于各单因素参数。n 结论:三维CT定量联合定性参数logistic回归模型能较好地预测pGGN的侵袭程度。“,”Objective:To explore the value of the logistic regression model with three-dimensional CT quantitative parameters in combination with qualitative parameters in predicting the invasiveness of pure ground glass nodules (pGGN).Methods:The clinical data and image features of 191 patients (196 lesions) with pGGN on CT confirmed as lung adenocarcinoma by pathology from April 2019 to December 2019 in Anhui Chest Hospital were retrospectively analyzed. Totally, 196 lesions were divided into atypical adenomatous hyperplasia (AAH)+adenocarcinoma in situ (AIS)+minimally invasive adenocarcinoma (MIA) group (n n=128) and invasive adenocarcinoma (IAC) group (n n=68). CT quantitative parameters included the maximum diameter, volume, average CT value and quality of pGGN, and the qualitative parameters included the intrinsic vascular changes, abnormal air-bronchogram, lobulated signs, bubble-like sign, pleura-traction sign, and fuzzy tumor-lung interface sign. The Mann-Whitney U test was used to compare the quantitative parameters and the Pearson χn 2 test was used to compare the qualitative parameters between two groups. The independent predictors of IAC and predictive probability value were screened by univariate analysis in combination with multivariate logistic regression analysis. The ROC curves were drawn to compare the diagnostic probability of logistic regression prediction probability and each single parameter.n Results:There were statistically significant differences in maximum diameter [0.92(0.77,1.14) cm vs. 1.41(1.12, 1.93) cm, n Z=-7.366, n P<0.001], volume[0.31(0.20, 0.53) cmn 3 vs. 0.88(0.41, 2.00) cmn 3, n Z=-6.254, n P<0.001], average CT value[-571.5(-637.2, -477.0) HU vs. -418.1(-532.4, -338.5) HU,n Z=-5.882, n P<0.001], quality[0.14(0.09, 0.25) g vs. 0.42(0.26, 1.21) g,n Z=-7.438, n P<0.001], intrinsic vascular changes(23 vs. 49, χ2=55.906,n P<0.001), abnormal air-bronchogram(13 vs. 30, χ2=29.908,n P<0.001) and pleura-traction sign(39 vs. 32, χ2=5.291,n P=0.021) between the two groups. The logistic regression analysis showed that the maximum diameter, average CT value, intrinsic vascular changes and abnormal air-bronchogram were the independent risk factors of IAC, and the odds ratio value(95%CI) were 10.624(1.275-88.522), 1.004(1.000-1.008), 3.424(1.458-8.043) and 2.993(1.114-8.043), respectively. The ROC curve demonstrated that the area under the curve, sensitivity and specificity of the logistic regression model were 0.899, 0.912, and 0.711 respectively, which were better than separate analysis results from each single parameter.n Conclusion:The logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters can predict the invasiveness of pGGN better.