Patients with a nomogram-predicted high Ki-67 LI exhibited worse RFS.<h4>Conclusion</h4>The nomogram utilizing clinical and CT features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma demonstrated excellent performance, clinical utility, and prognostic significance, suggesting that this nomogram is a noninvasive personalized approach for the preoperative prediction of Ki-67 expression. The gene discussed is MKI67; the disease is lung adenocarcinoma.