孤立性肺结节的危险因素分析

目的探讨影响孤立性肺结节良、恶性判断的危险因素。方法回顾性分析2004年1月至2013年12月经手术切除并经病理明确诊断孤立性肺结节的189例患者的资料。对以下资料:(1)年龄、性别、民族、吸烟史及吸烟量、临床症状、既往肿瘤史、肿瘤家族史;(2)实验室检查结果:血清CEA、血清肿瘤特异性生长因子(TSGF)、C-反应蛋白、红细胞沉降率;(3)影像学检查资料:肿瘤最大径、有无钙化、毛刺、分叶、胸膜凹陷征、CT强化峰值、PET-SUV值,先进行单因素分析,有统计学意义的再进行多因素Logistic回归分析。结果术后病理证实良性病变71例,恶性病变118例(62.43%),单因素分析显示,患者年龄、吸烟量、病变直径、钙化、毛刺、胸膜凹陷征、CT强化峰值、PET-SUV值、血清CEA、血清TSGF在良、恶性病变中的差异有统计学意义。多因素Logistic回归分析结果发现孤立性肺结节的危险因素有:患者年龄、病变大小、钙化、CT强化峰HU值、血清CEA及血清TSGF。结论患者年龄、血清CEA、血清TSGF、肿瘤最大径、伴有钙化、CT强化峰值,对判断肺结节的良、恶性有显著意义。

A multivariate risk factors analysis study contributing to solitary pulmonary nodules

Objective To review the risk factors affecting the definite pathological diagnosis of solitary pulmonary nodules（SPN）. Methods A retrospective study was conducted in 189 patients got definite pathological diagnosis of solitary pulmonary nodules from January 2004 to December 2013.The following factors were evaluated： age, gender, nation, history and quantity of smoking, symptoms, history of tumor, family history of tumor, serum CEA, serum TSGF, C-reactive protein, ESR, diameter, calcification, spicular sign, border, lobulated, the enhanced CT peak value, PET-SUV. Single factor analysis and multivariate logistic regrossion analysis were used to find the risk factors affecting the definite pathological diagnosis of solitary pulmonary nodules. Results Pathologic exam showed that there were 71 benign lesions, 118 malignant lesions（62.43%）. Single factor analysis showed that there were significant differences in age, smoking, diameter, calcification, burr, plcural indentation, the enhanced CT peak value, PET-SUV, serum CEA, serum TSGF between benign and malignant lesions. Further multivariate logistic regression analysis showed that age, serum CEA, serum TSGF, diameter, calcification, the enhanced CT peak value arc the risk factors in judgement character of SPN. Conclusion Age,serum CEA, serum TSGF of patient and the diameter, calcification, the enhanced CT peak value of tumor are significant risk factors in judgment character of SPN.