Introduction Pulmonary ground-glass opacity (GGO) observed on computed tomography (CT) is widely regarded as a diagnostic feature of lung adenocarcinoma. However, a significant radiological predictive sign remains controversial. In this retrospective study, we conducted a comprehensive analysis of 206 patients with GGO to establish a correlation analysis model between CT images and diagnosis of GGO nodules.Method Histopathologic specimens were obtained from 206 patients. The clinical data, pathologic findings, and thin-section CT features of solid, pure GGO (pGGO), and mixed GGO (mGGO) nodules were compared using rigorous statistical methods, such as t-test, Fisher’s exact test, or univariate logistic regression analysis.Results Significant differences were observed among the three groups in terms of patient demographics, including gender, smoking history, and nodule size. Morphologic CT characteristics, such as the presence of spiculated sign, lobulated sign, vascule sign bubble-lucency sign, or pleural retraction, exhibited significant differences among the solid nodule, pGGO, and mGGO groups. However, no significant differences were observed in terms of air-bronchogram sign. Notably, the incidence of malignancy was significantly higher in pGGO nodules (76.52%) than in solid (48.48%) and mGGO (73.86%) nodules. Patients with mGGO had up to 2.988 times higher hazard of malignant lesions than those with solid nodules (p=0.036). Similarly, the hazard of malignant lesions was 2.941 times higher in patients with pGGO than in those with solid nodules (p=0.007).Conclusion Based on our comprehensive analysis, patients presenting with a mGGO or pGGO on CT scans were more likely to be diagnosed with lung cancer.

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