微波热凝及局部照射治疗对喉结核抗结核治疗效果的影响

目的观察微波热凝及局部照射治疗对喉结核抗结核治疗效果的影响。方法选取2018年10月至2022年9月河北省胸科医院的喉结核病人84例,分为对照组与观察组各42例,对照组采用规范化2HRZE/4HR抗结核方案治疗,观察组在对照组治疗的基础上加用微波热凝及局部照射治疗,两组均治疗6个月。观察两组治疗2、3、6个月的痰菌转阴率及临床症状改善时间,比较两组治疗前、治疗6个月的炎症指标[γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素-2(IL-2)]变化情况,记录两组治疗期间不良反应发生情况。结果观察组治疗2、3、6个月的痰菌转阴率高于对照组(32.50%、55.00%、95.00%比12.50%、32.50%、77.50%,P<0.05);观察组声音嘶哑[(9.50±1.26)d比(10.85±1.69)d]、咽部不适/疼痛[(5.88±1.30)d比(7.73±1.50)d]、咳嗽症状改善时间[(11.50±2.26)d比(13.25±2.31)d]短于对照组(P<0.05);治疗6个月,两组IFN-γ、TNF-α、IL-2水平均降低,且观察组较对照组低(P<0.05);两组各种不良反应发生率比较,差异无统计学意义(P>0.05)。结论微波热凝及局部照射辅助治疗喉结核能显著缩短病人临床症状改善时间,提高痰菌转阴率,降低机体炎症指标水平,且安全可靠。

振动排痰频率对重症颅脑损伤患者安全性的观察

目的通过观察不同频率下机械振动排痰操作对有颅内压增高风险的重症颅脑损伤患者生命体征、颅内压、脑灌注压的影响,判断其安全性以及不同频率下气道廓清效果。方法选取2020年11月至2023年7月入住皖南医学院弋矶山医院神经外科重症监护室的40例持续颅内压(intracranial pressure,ICP)监测重症颅脑损伤患者,随机分为两组,第一组患者第一天采用高频率排痰第二天采用低频率排痰方法进行排痰,收集高频率和低频率数据。另一组患者第一天采用低频率排痰第二天采用高频率排痰方法进行排痰,收集高频率和低频率数据。高频率振动频率为35 Hz,低频率振动频率20 Hz。将两组患者采用低频率排痰数据纳入低频组、高频率排痰数据纳入高频组。比较低频组和高频组患者机械振动排痰操作前后及操作中患者颅内压(intracranial pressure,ICP)、脑灌注压(cerebral perfusion pressure,CPP)、平均动脉压(mean arterial pressure,MAP)、脉搏氧饱和度(Pulse Oxygen Saturation,SPO 2)、心率(heart rate,HR)、呼吸(respiratory rate,RR)、操作前后2 h内痰液量。第1天排痰操作前半小时和第2天排痰后半小时抽取动脉血样比较血气分析结果。结果低频组患者操作前HR与操作中HR有统计学有差异(P<0.05),其余指标均无统计学差异(P>0.05),高频组患者操作前HR与操作中HR以及操作中RR与操作后RR有统计学差异(P<0.05),其余指标均无统计学差异(P>0.05)。组间比较高频组与低频组患者HR差值有统计学差异(P<0.05),其余指标无统计学差异(P>0.05)。两组患者痰液引留量均较排痰前增多且高频率组痰液量高于低频率组有统计学差异(P<0.05)。血气分析方面操作前与操作后PaCO 2有统计学差异(P<0.05),其余各项指标均无统计学差异(P>0.05)。结论振动排痰操作有助于改善气道分泌物的清除率,排痰效果随着频率的增加排痰液引流效果更好。有颅内压增高风险的重症颅脑损伤患者可在较高的振动频率排痰时受益。

痰涂片、固体培养法、GeneXpert MTB/RIF单独及联合检测结核分枝杆菌能力的比较

目的 评估痰涂片、固体培养法、 Gene Xpert MTB/RIF单独及联合检测对结核分枝杆菌的检出能力。方法 选取2019年1月-2024年3月在天津市蓟州区人民医院结核门诊就诊的疑似肺结核的患者568例,满足同时送检痰涂片、固体培养法、GeneXpert MTB/RIF三种检测方法,以临床最终诊断结果为金标准,评价上述三种方法检出结核分枝杆菌的能力。结果 在568例疑似肺结核患者中,临床最终诊断依据《肺结核诊断》(WS 288—2017)[1]标准进行,肺结核患者280例,非结核患者288例。痰涂片、固体培养法、GeneXpert MTB/RIF检测结核分枝杆菌的灵敏度分别为60.4%、84.3%、95.0%,差异具有统计学意义(χ^(2)=109.616,P<0.001),其中GeneXpert MTB/RIF灵敏度最高;三种检测方法特异度比较结果显示,差异无统计学意义(χ^(2)=1.002,P=0.606)。三种方法两两组合检测分析结果显示,痰涂片+固体培养法、痰涂片+GeneXpert MTB/RIF、固体培养法+GeneXpert MTB/RIF灵敏度分别为92.9%、98.2%、99.6%,差异具有统计学意义(χ^(2)=23.893,P<0.001),其中固体培养法+Gene Xpert MTB/RIF组合的灵敏度最高。两种方法联合检测特异度比较结果显示,差异无统计学意义(χ^(2)=0.502,P=0.778)。三种方法联合检测的灵敏度为100%,与金标准相一致;特异度比较结果显示,差异无统计学意义(χ^(2)=2.007,P=0.157)。结论 三种方法联合检测结核分枝杆菌优于单独检测及任意两种方法联合检测,所以建议三种方法同时检测有助于提高结核分枝杆菌的检出率,避免漏诊。

振动辅助排痰配合乙酰半胱氨酸雾化吸入治疗婴幼儿肺炎的临床效果

目的观察振动辅助排痰配合乙酰半胱氨酸雾化吸入治疗婴幼儿肺炎的临床效果。方法选取2021年8月—2022年8月萍乡市妇幼保健院儿内一科收治的肺炎患儿80例,采用随机数字表法分为观察组和对照组,各40例。2组患儿均予常规治疗,对照组在常规治疗基础上加用吸入用乙酰半胱氨酸溶液治疗,观察组在对照组基础上配合振动辅助排痰,2组患儿均治疗7 d。比较2组临床效果、症状体征(发热、咳嗽、气喘、肺部湿性啰音)消失时间、住院时间、住院费用,治疗前后血常规指标[白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平以及不良反应。结果观察组治疗总有效率为97.50%,高于对照组的85.00%(χ^(2)=3.914,P=0.048);观察组发热、咳嗽、气喘消失时间、肺部湿性啰音消失时间及住院时间均短于对照组,住院费用低于对照组(P<0.01);治疗7 d后,2组WBC及血清CRP、PCT水平均较治疗前下降,且观察组低于对照组(P<0.01);观察组与对照组不良反应总发生率(12.50%vs.10.00%)比较差异无统计学意义(χ^(2)=0.125,P=0.723)。结论振动辅助排痰配合乙酰半胱氨酸雾化吸入治疗婴幼儿肺炎的临床效果较好,可有效缓解患儿症状表现与炎性反应程度,且安全性较高。

5例重度急性呼吸窘迫综合征病人早期清醒俯卧位通气的护理

总结5例重度急性呼吸窘迫综合征病人应用俯卧位通气联合高频胸壁振荡排痰治疗的护理经验。护理内容包括:采取俯卧位通气改善氧合,俯卧位期间间断联合高频胸壁振动排痰治疗,每日目标导向吹气球锻炼,早期下床活动,营养支持。实施多层面的干预措施,改善病人预后。5例病人经过精心的治疗和护理,顺利出院。

2020—2022年平南县人民医院初治空洞型肺结核的流行病学研究

目的分析2020—2022年平南县人民医院初治空洞型肺结核的流行病学特点。方法收集2020—2022年在本院初治的空洞型肺结核患者基础数据、成功治疗率、痰液平均转阴时间、治疗期间不良事件、转诊例数及丢失患者末次痰液检测情况,分析疾病相关的流行病学特点。结果共纳入初治空洞型肺结核患者598例,平均年龄(49.87±18.77)岁;男性占比80.60%,女性占比19.40%;职业分布占比由高到低依次为农民、工人、学生、其他;成功治疗率为81.44%,痰液平均转阴时间(1.71±0.96)个月;治疗期间不良事件总发生率为17.73%,转诊率为0.33%;治疗期间,患者丢失率为7.36%,丢失患者中末次痰检阳性率为38.64%。结论初治空洞型肺结核患者中男性居多,患者在年龄分布上呈双峰形态,成功治疗率较低,丢失患者中痰液涂片阳性患者数量呈现增长趋势,值得被重视并采取措施预防。

基于慢性阻塞性肺疾病不同肺功能严重程度患者诱导痰微生态多样性研究

目的使用深度宏基因组测序(Metagenomic sequencing,mNGS)技术(单个样本原始数据量>=12G),比较不同肺功能分级慢性阻塞性肺疾病(简称慢阻肺)患者诱导痰微生物组的物种和基因功能差异,探索诱导痰微生物组种群和基因功能变化与肺功能的关系,为慢阻肺肺功能损伤机制提供线索。方法选取2022年1月-2023年10月在上海嘉定区中心医院呼吸与危重症医学科诊断为慢阻肺的患者49例,根据肺功能分级分为轻度组(FEV_(1)pred≥50%,n=21),中度组(30%≤FEV_(1)pred<50%,n=13)和重度组(FEV_(1)pred<30%,n=15)。收集患者诱导痰液,然后进行DNA提取、非靶向宏基因组下一代测序(mNGS)和生物信息学分析,比较各亚组Alpha、Beta多样性、菌群构成及相对丰度的差异,并使用KEGG数据库、eggNOG数据库、cazy数据库进行基因和功能差异分析。结果研究发现,三组之间的Alpha多样性存在显著差异,Beta多样性、物种构成及相对丰度无统计学差异。在属水平,沙尔菌属(Schaalia)、罗斯氏菌属(Rothia)在重度组中丰度较高,纤毛菌属(Leptotrichia)在轻度组中丰度更高;在种水平,黏液罗氏菌(Rothia mucilaginosa)、龋齿放线菌(Schaalia odontolytica)和邻接短链小球菌(Granulicatella adiacens)在重度组中丰度较高。LEfSe(LDA Effect Size)分析结果显示,K13993(Hsp20蛋白家族)、GH89(α-N-乙酰氨基葡萄糖酶家族)、CBM61(碳水化合物结合模块家族61)丰度在轻度组比中度组、重度组中丰度高。结论随着肺功能下降,慢性阻塞性肺病患者微生物组多样性降低,部分蛋白家族丰度发生改变。这些发现表明,慢阻肺患者痰液微生物组群落失调与肺功能损伤的严重程度有关。

利福喷丁与利福平在肺结核治疗中的疗效及其对肝功能影响研究

目的分析利福喷丁与利福平在肺结核治疗中的疗效及其对肝功能影响。方法选取本院收治的82例肺结核患者为研究对象,均使用抗结核治疗方案,将采用利福平片治疗的41例患者纳入对照组,将采用利福喷丁治疗的41例患者纳入观察组,观察两组痰涂片转阴率、空洞闭合率、病灶吸收率、临床治疗效果、肝功能情况、T细胞亚群水平、鸟苷酸结合蛋白5(GBP5)表达量及药物不良反应。结果用药后6个月,观察组涂片转阴率、空洞闭合率、病灶吸收率、治疗有效率较对照组高(P均<0.05);两组肝功能各指标均较治疗前高(P<0.05),但观察组均较对照组低(P<0.05);两组CD3+、CD8^(+)指标比治疗前低,CD4^(+)、CD4^(+)/CD8^(+)指标均较治疗前高(P<0.05),GBP5均较治疗前低(P<0.05),且观察组比对照组更显著(P均<0.05);观察组不良反应较对照组少(P<0.05)。结论肺结核治疗中采用常规抗结核治疗方案的同时辅以利福喷丁治疗效果相对更好,且药物不良反应发生率低,使用价值较好。

Detection of DNA Aneuploidy in Exfoliated Airway Epithelia Cells of Sputum Specimens by the Automated Image Cytometry and Its Clinical Value in the Identification of Lung Cancer

To evaluate the value of detecton of DNA aneuploidy in exfoliated airway epithelia cells of sputum specimens by the automated image cytometry for the identification of lung cancer, 100 patients were divided into patient group (50 patients with lung cancer) and control group (30 patients with tuberculosis and 20 healthy people). Sputum was obtained for the quantitative analysis of DNA content of exfoliated airway epithelial cells with the automated image cytometry, together with the examinations of brush cytology and conventional sputum cytology. Our results showed that DNA aneuploidy (DI>2.5 or 5c) was found in 20 out of 50 sputum samples of lung cancer, 1 out of 30 sputum samples from tuberculosis patients, and none of 20 sputum samples from healthy people. The positive rates of conventional sputum cytology and brush cytology were 16 % and 32 %, which was lower than that of DNA aneuploidy detection by the automated image cytometry (P<0.01,P>05). Our study showed that automated image cytometry, which uses DNA aneuploidy as a marker for tumor, can detect the malignant cells in sputum samples of lung cancer and it is a sensitive and specific method serving as a complement for the diagnosis of lung cancer.

Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in Kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis

Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in Kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in Kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.

Application of Inflammatory Markers in Induced Sputum in Stable Chronic Obstructive Pulmonary Disease Patients with Positive Bronchodilation Tests

Positive bronchodilation (BD) tests can be noticed in some stable chronic obstructive pulmonary disease (COPD) patients.The characteristics of airway inflammation in this entity remain unclear.Our study aimed to identify the characteristics of airway inflammation in stable COPD patients with positive BD tests.The airway inflammation was assessed in 88 patients with stable COPD using the examination of induced sputum in the aftermath of lung function and BD tests.Cellular counts and the levels of molecular markers including eosinophil cationic protein (ECP),myeloperoxidase (MPO),interleukin-5 (IL-5),and IL-8 were assayed by Wright's stain,Immuno-CAP system,and ELISA,RT-PCR.Among the 88 patients with stable COPD,20 (22.7%) showed positive BD tests.The values of eosinophils (4.7%±3.4%) and ECP (90.1±41.6 ng/mL) in induced sputum in stable COPD patients with positive BD tests were markedly elevated as compared with those in stable COPD patients with negative BD tests or in healthy controls (all P<0.05),but significantly lower than those in asthmatic patients (all P<0.01).The IL-5 in sputum supernatant was significantly decreased in stable COPD patients with positive BD tests as compared with the patients with asthma (12.5±7.8 vs.48.2±26.0 ng/mL;P<0.01).However,healthy controls exhibited similar concentrations of IL-5 in induced sputum with patients with stable COPD,whether with positive or negative BD tests (all P>0.05).Moreover,the values of neutrophils (61.8%±15.1%),MPO (574.0±111.8 ng/mL),and IL-8 (32.6±13.4 ng/mL) in induced sputum in stable COPD patients with positive BD tests were significantly higher than those in asthmatics or normal controls (all P<0.01).However,the values of the above inflammatory markers in induced sputum were similar among stable COPD patients with positive or negative BD tests (all P>0.05).The stable COPD patients with positive BD tests may present not only eosinophilic airway inflammation but also neutrophilic airway inflammation.

The Feasibility of Sputum Transportation System in China: Effect of Sputum Storage on the Mycobacterial Detection

Sputum transportation from county-level to prefecture-level is an ideal strategy to cover the shortage of the laboratory capability in the resource-poor setting. Here, we firstly evaluated the feasibility of sputum transportation system in China by analyzing the culture and molecular diagnosis results from 1982 smear-positive patients with different delay in processing for culture.

Occurrence of <i>N</i>-Acyl Homoserine Lactones in Extracts of Bacterial Strain of <i>Pseudomonas aeruginosa</i>and in Sputum Sample Evaluated by Gas Chromatography–Mass Spectrometry

This study presents a fast, accurate and sensitive technique using gas chromatography-mass spectrometry (GC-MS) for the identification and quantification of N-acyl homoserine lactones (AHLs) in the extracts of bacterial strain of Pseudomonas aeruginosa and sputum sample of a cystic fibrosis patient. This method involves direct separation and determination of AHLs by using GC-MS as simultaneous separation and characterization of AHLs were possible without any prior derivatiza-tion. Electron ionization resulted in a common fragmentation pattern with the most common fragment ion at m/z 143 and other minor peaks at 73, 57 and 43. The limit of detection for N-butanoyl, N-hexanoyl, N-octanoyl, N-decanoyl, N-dodecanoyl and N-tetradecanoyl homoserine lactones was 2.14, 3.59, 2.71, 2.10, 2.45 and 2.34 μg/L, respectively. The presence of AHLs in the culture of P. aeruginosa strain and spu-tum of a cystic fibrosis patient was achieved in selected ion monitoring (SIM) mode by using the prominent fragment at m/z 143.

Comparison of Sputum Smear Microscopy and Rapid Tuberculosisantibody Detection Test Kits for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

The SSM （sputum smear microscopy） and five immunochromatographic tuberculosis antibody detection tests （DiaSpot TB, Spodex TB, SD Rapid TB, Clinotech TB Screen and Precious One-step TB） were compared for diagnosis of active TB at the Leprosy and Tuberculosis Referral Hospital, Uzuakoli, Abia State, Nigeria. Sputum specimens from 150 study participants （male/female ratio, 0.81） were cultured on Lowenstein-Jensen slopes and direct smears were stained by Ziehl-Neelsen technique and examined by light microscopy. Sera were tested for anti-TB antibodies using the rapid TB tests. A total of 91 participants were culture positive, 79 （86.8%） for M. tuberculosis and 12 （13.2%） for nontuberculous mycobacteria. The sensitivity of SSM was 50% （95% CI： 39.0-61.0） and specificity was 92.3% （95% CI： 86.4-98.2） in those culture positive for M. tuberculosis. The sensitivity and specificity of the Rapid TB tests ranged from 24.1-39.2% and 78.4-87.8%, respectively. None of the five rapid TB tests had acceptable level of accuracy for diagnosis of active TB. The sensitivity of SSM though moderate is inadequate for long term TB control in this setting.

Follow-up Study of Retreatment TB Patients with Sputum Smear and/or Culture Positive Two Years after They were Declared Cured with First-line Anti-TB Drugs in Shandong Province

This study aimed to learn the recurrence rate in the retreatment TB patients with sputum smear and/or culture positive （ss＋ and/or c＋） two years after they were declared cured, and to explore causes of recurrence in order to improve long-time treatment outcome. 5 cities were selected as research locations. Recurrence of TB was judged by chest X-ray examination together with sputum smear and culture examination.

EXAMINATION OF SPUTUM SEDIMENT PARAFFIN SECTION OF DIAGNOSIS OF LUNG CANCER

To establish the rapid and accurate methods for detecting cancer cells from the sputum of patients with lung cancer. Methods: Sputum sediment section examination and sputum smear examination were performed. For 142 cases of lung cancer patients diagnosed by bronchia fibrous lens and confirmed by pathologic diagnosis. Results: (a) The positive diagnosis rate of lung cancer cell was 71.83% (102/142) when using sputum sediment examination while that was 32.39% (46/142) when using sputum smear examination, when using sputum sediment examination jointly with sputum smear examination, the positive diagnosis rate of lung cancer was 91.55% (130/142). According to the positive diagnosis rate of lung cancer, the sputum sediment examination was significantly higher than sputum smear examination (P<0.001), joint examination of both of them was significantly higher than the single sputum sediment examination (P<0.001); (b) As to the histopathological types of lung cancers, 66 cases could be identified among 102 cases whom were confirmed by sputum sediment examination, the identification rate was 64.71%; and 8 cases could be identified among 46 cases whom were confirmed by sputum smear examination, with an identification rate of 17.39%, it was significantly lower than that by sputum sediment examination (P<0.001); (c) Immunohistochemistry technique could be used in the sections of sputum sediment to identify some histopathological types which could not be identified by routine HE stain, with an identification rate of 94.44% (34/36). Conclusion: the sputum sediment examination has some advantages compared to the sputum smear examination such as the specimen may include more materials, the higher cancer cell identification positive rate and immunohistochemistry method can be used to identify the histopathological type.

An HIV 1/2 point of care test on sputum for screening TB/HIV coinfection in central India-Will it work?

Objective:To determine whether the OraQuick(?).HIV-1/2 Assay(OraSure Technologies, Inc.,Bethlehem,PA,USA) in sputum is a valid tool for HIV surveillance among TB patients. Methods:A cross sectional study was carried out on sputa of patients diagnosed with tuberculosis.Sputa were tested for antibodies to HIV using OraQuick. HIV-1/2 Assay(OraSure Technologies,Inc.,Bethlehem,PA,USA).The results were compared with results of serum ELISA.Results:Compared to serum ELISA,the OraQuick(?).HIV-1/2 Assay in sputum specimens reported 90%sensitivity(9/10)and 100%specificity(307/307),with a positive predictive value of 100%(95%CI:66.37%-100.00%)and a negative predictive value of 99.68%(95%CI:98.20%-99.99%). Conclusions:This testing method may provide a useful strategy for conducting HIV surveillance in possible co-infected TB patients at peripheral centres.Since there is no investment on infrastructure,it may be possible for paramedical health professionals to carry out the test. particularly in areas with low HIV endemicity.

Quality of Sputum Specimen Samples Submitted for Culture and Drug Susceptibility Testing at the National Tuberculosis Reference Laboratory-Uganda, July-October 2013

Setting: The Uganda National Tuberculosis Reference Laboratory (NTRL) in Kampala. Objective: The proportion of poor quality specimens received for drug susceptibility testing (DST) at the NTRL and factors contributing to poor specimen quality were assessed. Design: A cross-sectional study was conducted of sputum samples received at the NTRL from patients at high risk for multi-drug-resistant tuberculosis (MDR TB) during July-October 2013. Demographic, clinical, and bacte-riological data were abstracted from laboratory records. A poor quality sample failed to meet any one of four criteria: ≥3 milliliter (ml) volume, delivered within 72 hours, triple packaged, and non-salivary appearance. Results: Overall, 365 (64%) of 556 samples were of poor quality;89 (16%) were not triple packaged, 44 (8%) were <3 mls, 164 (30%) were not delivered on time, and 215 (39%) were salivary in appearance. Poor quality specimens were more likely to be collected during the eighth month of TB treatment (OR = 2.5, CI = 1.2 - 5.1), from the East or Northeast zones (OR = 2.2, CI = 1.1 - 4.8), and from patients who previously defaulted from treatment (OR = 1.9, CI = 1.1 - 3.2). Conclusion: The majority of sputum samples had poor quality. Additional efforts are needed to improve quality of samples collected at the end of treatment, from East and Northeast zones, and from patients who had previously defaulted.

The value of chest CT scan and tumor markers detection in sputum for early diagnosis of peripheral lung cancer

Objective To investigate the diagnostic value of chest CT scan combined with telomerase activity and p16 gene methylation from exfoliated cells of sputum in 55 cases of solitary pulmonary nodules (SPN; ≤30 mm)suspected early peripheral lung cancer. Methods The sputum specimens from 34 cases of cancer nodules and 21 cases of benign lesion were detected for telomerase activity by TRAP PCR ELISA and p16 gene methylation by PCR based methylation analysis. Results The qualitative diagnostic accuracy of CT scan was 61.8%(34/55) for SPN provided by pathology. Cytology analysis of sputum was positive in 13 cases (38.2%). Telomerase activity was positive in 29 cases: sensitivity was 79.4%, specificity was 90.5%, accuracy was 83.6%; p16 gene methylation was found in 11 cases: sensitivity was 32.4%, specificity was 100.0% , and accuracy was 58.2%. The sensitivity was increased to 86.1% by combination of telomerase activity and p16 gene methylation. Compared with nodules without malignant CT signs, expression of telomerase activity and p16 methylation of SPN with malignant CT signs (lobulation or spiculate protuberance or spicule sign) had a significant difference ( P <0.01). Conclusion The results suggest that chest CT scan combined with telomerase activity and p16 gene methylation detection in sputum for patients with peripheral lung cancer may enhance the diagnostic value of radiology and conventional cytology.