190例肺部占位性病变患者临床特征和实验室资料特点分析  

Clinical and laboratory data analysis of 190 patients with lung space-occupying lesion

作　　者：闫雪波[1] 王炯[1] 李峰[1] Yan Xuebo;Wang Jiong;Li Feng(Dept of Geriatric Respiratory Medicine and Critical Care Medicine,the Institute of Respiratory Diseases,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)

机构地区：[1]安徽医科大学第一附属医院干部呼吸与危重症医学科、呼吸病研究所,合肥230022

出　　处：《安徽医科大学学报》2021年第1期157-160,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金(编号:1608085MH190);安徽医科大学第一附属医院博士启动基金(编号:3101005001015);安徽医科大学第一附属医院国家青年基金培育计划(编号:2010KJ14);2014安徽省高校优秀青年人才支持计划(编号:皖教秘人[2014]181号);安徽医科大学2020年度大学生创新创业训练计划(编号:校创新字[2020]3号)。

摘　　要：目的了解肺部占位的临床特征及实验室资料特点,提高对肺部占位性病变性质的认识和诊断能力。方法对已经进行气管镜活检或者CT引导下经皮肺穿刺活检,取得明确病理结果的190例肺部占位患者,进行良恶性病变分组,恶性病变组进一步按病理类型分组,比较各组间差异,详细记录全部患者的临床特征及实验室资料,进行分析比较。结果 (1) 190例患者,良性病变患者37例(19.47%),恶性病变患者153例(80.53%),良性病变组与恶性病变组间在吸烟、肺癌三项和热休克蛋白90(HSP90)方面差异有统计学意义;92.77%的吸烟伴有肺癌三项升高或HSP90升高的肺内占位性病变是恶性病变。但良性病变组与恶性病变组间在年龄、发病病程、性别、家族史、C反应蛋白(CRP)、异常糖链蛋白和D-二聚体等方面差异均无统计学意义。(2)恶性病变组中以肺腺癌最多,占50.98%;其次是鳞癌,占30.07%;小细胞癌占17.65%,其他类型占1.31%。不同类型肺癌在发病病程、性别、家族史、吸烟、CRP和肺癌三项方面差异有统计学意义;但在年龄、异常糖链蛋白、HSP90和D-二聚体等方面差异均无统计学意义。结论患者吸烟、伴有肺癌三项或HSP90升高的肺部占位系恶性病变可能性大,结合临床特征及实验室资料特点可以对恶性病变类型进行进一步判断。Objective To understand the clinical characteristics and laboratory data of lung space-occupying lesion, and to improve the understanding and diagnostic ability of the nature of lung space-occupying lesion. Methods 190 patients with lung-occupying space lesion who have clear pathological results by tracheoscopic biopsy or CT guided percutaneous lung biopsy were divided into benign and malignant lesion group. Malignant lesion group were further divided according to pathological types. The clinical characteristics and laboratory data of all patients were recorded in detail, then analyzed and compared between the groups. Results(1) Among 190 patients, 37(19.47%) had benign lesions while 153(80.53%) had malignant lesions. There were significant differences in smoking, lung cancer and HSP90 between benign lesion group and malignant group. 92.77% of smoking patients with high three indicators of lung cancer or HSP90 were malignant lesions. However, there was no significant difference in age, course of disease, gender, family history, CRP, abnormal glycoprotein and D-dimer between benign lesion group and malignant lesion group.(2) In the malignant lesion group, adenocarcinoma was the most, accounting for 50.98%;squamous cell carcinoma was the second, accounting for 30.07%;small cell carcinoma was 17.65%, and other types accounted for 1.31%. There were significant differences in the course of disease, gender, family history, smoking, CRP and lung cancer among different types of lung cancer, but there was no significant difference in age, abnormal glycan protein, HSP90 and D-dimer. Conclusion For the patients with smoking, and high three indicators of lung canceror high HSP90, the lung-occupying space lesion are more likely to be malignant. Combined with the clinical characteristics and laboratory data, the malignant lesion can be further diagnosed.

关 键 词：肺部占位性病变 良性病变 恶性病变 

分 类 号：R563.9[医药卫生—呼吸系统]