肺结节224例临床和影像学特征及恶性结节的风险因素分析

Clinical and imaging characteristics of 224 cases of pulmonary nodules and risk factors of malignant nodules

目的探讨肺结节的临床、影像学特征及恶性结节的风险因素。方法抽取2018年1月至2021年12月经河南中医药大学第一附属医院胸外科行手术切除和病理确诊的肺结节患者224例,其中良性结节113例(50.4%,113/224),恶性结节111例(49.6%,111/224)。分析224例患者的临床及影像学资料。结果良性组和恶性组一般资料中性别、肿瘤家族史比较差异未见统计学意义(P>0.05),年龄、吸烟、肿瘤史比较差异有统计学意义(P<0.05)。结节良性组与恶性组活化部分凝血活酶时间、凝血酶时间、鳞状细胞癌相关抗原、糖类抗原153水平比较差异未见统计学意义(P>0.05),恶性组其余实验室指标水平均高于良性组(P均<0.05)。结节良性组与恶性组结节大小、风险级别、Lung-RADS分级、毛刺征、血管征、空泡征、胸膜牵拉征比较差异有统计学意义(P<0.05),其中恶性组结节大小、毛刺征、血管征、空泡征、胸膜牵拉征均高于良性组(P均<0.05)。结论结节长径、D-二聚体、癌胚抗原、恶性肿瘤特异性生长因子、吸烟史、肿瘤史、毛刺征、胸膜牵拉征、空泡征为肺恶性结节的独立风险因素。

Objective To investigate the clinical and imaging characteristics of pulmonary nodules and related risk factors of malignant nodules.Methods A total of 224 patients with pulmonary nodules which were resected by surgery and diagnosed by pathology in the Department of Thoracic Surgery of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2018 to December 2021 were selected,including 113 cases(50.4%,113/224)benign nodules,111 cases(49.6%,111/224)malignant nodules.The clinical and imaging data of the 224 patients were analyzed.Results There was no statistically significant difference between the benign group and the malignant group in the general data of gender and tumor family history(P>0.05);there were statistically significant differences in age,smoking and tumor history between the two groups(P<0.05).There was no statistically significant difference in the levels of activated partial thromboplastin time,thrombin time,squamous cell carcinoma antigen and carbohydrate antigen 153 between the benign group and the malignant group(P>0.05);the other laboratory indicators of the malignant group were higher than those of the benign group(all P<0.05).There were significant differences in nodule size,risk level,Lung-RADS grade,hairpin sign,vascular sign,vacuole sign and pleural traction sign between the benign group and the malignant group(P<0.05);in addition,the nodule size,hairpin sign,vascular sign,vacuole sign and pleural traction sign of the malignant group were higher than those of the benign group(all P<0.05).Conclusions Major diameter of nodule,D-dimer,carcinoembryonic antigen,tumor specific growth factor,smoking history,tumor history,hairpin sign,pleural traction sign and vacuole sign are independent risk factors for pulmonary malignant nodules.