Current studies indicate that lung adenocarcinomas (LUAD) presenting as ground-glass opacity (GGO) have a low likelihood of lymph node metastasis (LNM), with pure ground-glass nodules (pGGNs) posing almost no risk, while part-solid nodules (PSNs) carry a higher risk. Research shows that LNM risk increases with a higher solid component proportion (CTR>50%), larger nodule size, and elevated CEA levels. The dynamic evolution from pGGN to PSN (e.g., increasing solid components) signals higher metastasis risk. Evaluating nodule invasiveness using clinical and imaging features is crucial for guiding risk assessment and management. For highly invasive PSNs, lobectomy and systematic lymph node dissection are recommended. Thus, accurate assessment of tumor aggressiveness is essential for individualized surgical planning. This article reviews the relationship between GGO-type LUAD and mediastinal LNM