ObjectiveTo analyze the clinical, pathological, and radiological characteristics of solitary ground-glass opacity nodules (SGGN) of the lungs on high-resolution computed tomography (HRCT).MethodsA total of 328 resected SGGN were evaluated with HRCT from January 2008 to March 2018. The clinical, pathological, and radiological characteristics of these cases were analyzed.ResultsThree hundred and twenty-eight adenocarcinomas were observed. Patients with adenocarcinoma in non-smoking women (230, 70.1%) were more than men (98, 29.9%). All SGGN were at the stage IA or IB. Forty-eight patients (all were male) had smoking history, 19 patients with a history of cancer, and 60 patients had a family history of cancer, which including 32 patients with family lung cancer history. However, elevated blood tumor markers were rare in patients. The adenocarcinoma nodules included 10 (3.0%) atypical hyperplasia (AAH), 43 (13.1%) adenocarcinoma in situ (AIS), 71 (21.6%) minimally invasive adenocarcinoma (MIA), and 204 (62.2%) invasive adenocarcinoma (IPA). The positive expression rates of anaplastic lymphoma kinase (ALK-V), proto-oncogene tyrosine-protein kinase ROS (ROS-1) and programmed death ligand 1 (PDL-1) were 4.2% (6/143), 13.9% (20/144) and 17.8% (13/73), respectively. HRCT showed that there were 149 (45.4%) pure SGGN and 179 (54.6%) mixed SGGN, and the most common lesion was the superior lobe of right lung (138, 42.1%). The size, density, shape, and pleural tag of nodules were significant factors that differentiated IPA from AAH, AIS and MIA. All patients were followed up for an average of 3.32 months. All patients underwent surgical excision and no recurrence or metastasis of the tumor had occurred.ConclusionsThe size, density, shape, and pleural tag of SGGN on HRCT are found to be the determinant factors of IPA. Additionally, patients were all at the early clinical stage, and have high survival rate after surgical removal of the nodules. Moreover, the positive expression rate of ALK-V, ROS-1 and PDL-1 are very low in patients with SGGN.