Fisher判别在肺磨玻璃结节CT鉴别诊断中的应用

Application of Fisher Discriminant in Differential Diagnosis of Ground-glass Opacity by Spiral CT Scanning

目的：探讨Fisher判别对肺磨玻璃结节（ground-glass opacity,GGO）CT鉴别诊断的价值。方法：回顾性分析苏州大学附属第一医院2009年8月~2015年8月收治的经病理证实的GGO患者80例,对结节主要CT形态特征进行评价,采用卡方检验行单因素分析,以两组之间有统计学意义的CT征象为判别指标行fisher判别,采取刀切法估计误判率。结果：80例GGO分为两组,良性者29例,恶性者51例,单因素分析显示良恶性GGO结节形态、分叶征、毛刺征、胸膜凹陷征、空泡征以及病灶界面比较差异有统计学意义,以其为判别指标行Fisher判别,所得Fisher判别公式为Z=-1.864X1＋1.434X2＋2.091X3＋1.154X4＋0.492X5＋0.996X6＋0.677X7-1.008,误判率为13.7%,敏感性达91.7%,特异性78%,准确率86.3%。结论：Fisher判别模型诊断GGO具有较高的敏感性、特异性、准确性及临床实用价值。

Objective： To assess the differential diagnostic value of fisher discriminant in analyzing ground-glass opacity（GGO） by spiral CT scanning. Methods： A retrospective study was conducted in 80 cases of GGO, got definite pathological diagnosis, from August2009 to August 2015 in the First Affiliated Hospital of Soochow University. The CT morphological features were evaluated by x2-test and fisher discriminant was applied to the parameters with significant difference. Jackknife was used for estimating the rate of miscarriage justice. Results： 80 cases with GGO were divided into 2 groups： benign group（n=29）, malignant（n=51）. Single factor analysis showed that there were significant differences in nodules form, lobulated sign, spicule sign, pleural indentation sign, bronchus encapsulated air sign, nodule interface between benign and malignant lesions. The formula of fisher discriminant was Z=-1.864X1＋1.434X2＋2.091X3＋1.154X4＋0.492X5＋0.996X6＋0.677X7-1.008, the rate of miscarriage of justice was 13.7 %, the sensitivity and specificity were 91.7 %and 78 % respectively, the accuracy was 86.3 %. Conclusion： Fisher discriminant mode could effectively make differential diagnosis of GGO, which had high sensitivity, specificity, accuracy and value in clinical experience.