肺结节患者影像学特征分析

Analysis based on imaging characteristics in patient with pulmonary nodules

目的 探讨恶性肺结节患者影像学信息的相关危险因素及保护因素.方法 收集454例肺结节患者的一般个人信息和影像学信息,其中恶性312例,良性142例.校正个人信息中的混杂因素后,应用非条件Logistic回归方法,根据各因素的优势比（OR值）及其95％置信区间（95％ CI）分析影像学中恶性肺结节的相关危险及保护因素.结果 个人信息中有统计学差异的混杂因素包括：年龄较大（55岁及以上,OR =4.112;75岁及以上,OR=3.616）、有既往肿瘤史（OR=3.206）.校正个人信息后,恶性肺结节患者影像学信息中的危险因素包括有淋巴结肿大（OR=2.734,95％CI：1.257～ 5.946）、结节直径2 cm及以上（OR=10.477,95％CI：2.229～49.251）、呈现毛玻璃结节（OR=14.569,95％CI：3.320～63.928）、边缘粗糙（OR =3.113,95％CI：1.632～5.939）、有分叶（OR=4.508,95％CI：2.326～8.736）、有空泡征（OR =5.173,95％ CI：1.920～13.940）、有胸膜凹陷征（OR =2.076,95％ CI：1.078～3.999）,保护因素为结节有钙化（OR =0.208,95％ CI：0.091 ～0.479）.结论 在关注年龄较大、有既往肿瘤史的患者同时,也要关注胸部影像中呈现淋巴结肿大、结节直径大、毛玻璃结节、边缘粗糙、有分叶、有空泡征、胸膜凹陷症、结节无钙化的患者.

Objective To explore the hazards and protective factors among imaging characteristics in patients with malignant pulmonary nodules. Methods We used non-conditional logistic regression to analyze the risk factors as well as the protective factors of malignant pulmonary nodules among imaging characteristics based on the odds ratio （OR） and its 95% confidence interval （95% CI） after adjusting confounding factors inpatient information. All the data were obtained from 454 patients with pulmonary nodules, in which 312 were malignant and the rest were benign. Results The confounding factors with significant difference in patient information included elder age （ ≥ 55： OR = 4. 112;≥75 ： OR = 3. 616） , a precious history of tumors（ OR = 3. 206）. By adjusting those confounders, the risk factors of patients with malignant pulmonary nodules werelymphadenectasis （ OR =2. 734, 95% CI：I. 257 -5. 946） , diameters bigger or equal to 2 centimeters （ OR = 10. 477, 95% CI： 2. 229 -49.251 ） , ground glass opacity （ OR = 14. 569, 95 % CI：3. 320 - 63. 928 ） , rough edges （OR =3. 113, 95% CI：I. 632 - 5. 939）, lobulation （OR =4. 508, 95% CI： 2. 326 - 8. 736）, nodules with an area of air （OR =5. 173, 95% CI：1.920- 13. 940）, pleural indentation （OR =2.076, 95%CI： 1. 078 - 3. 999） , while the protective factor including calcification （ OR = 0. 208, 95% CI：0. 091 - 0. 479 ）. Conclusions While focusing on the patients who were older or had a precious history of tumors, attention also should be paid to signs of lymphadenectasis, bigger nodule size, grand glass opacity, rough edges, lobulation, nodules with an area of air, pleural indentation and without calcification in the chest radiography.