低剂量螺旋CT征象联合MDSCs对良恶性孤立性肺结节的鉴别诊断价值  

Value of Low-dose Spiral CT Signs Combined with MDSCs in the Differential Diagnosis of Benign and Malignant Solitary Pulmonary Nodules

作　　者：张志刚[1] 郭莹 吴艳 张舵 张仙虎 刘冲[1] ZHANG Zhigang;GUO Ying;WU Yan;ZHANG Duo;ZHANG Xianhu;LIU Chong(Department of Radiology,the First Central Hospital of Baoding City,Baoding,Hebei 071000,China)

机构地区：[1]保定市第一中心医院影像一科,河北保定071000

出　　处：《临床误诊误治》2023年第4期36-41,共6页Clinical Misdiagnosis & Mistherapy

基　　金：保定市科学技术局项目(2241ZF066)。

摘　　要：目的探讨低剂量螺旋CT征象联合外周血髓源性抑制细胞(MDSCs)对初诊孤立性肺结节(SPN)性质的鉴别诊断价值。方法选取2019年1月—2021年12月检出的SPN 185例,均行低剂量螺旋CT扫描,比较恶性、良性结节的影像学特点,采用多因素Logistic回归分析结节性质的影响因素,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析低剂量螺旋CT征象及MDSCs鉴别诊断结节性质的价值。结果恶性结节形态不规则、血管集束征、毛刺征、空气支气管征、棘状突起、胸膜凹陷征、分叶征所占比例高于良性结节(P<0.01)。恶性结节最长毛刺长度短于良性结节,MDSCs高于良性结节(P<0.01)。结节形态、血管集束征、毛刺征、空气支气管征、棘状突起、胸膜凹陷征、分叶征、最长毛刺长度、MDSCs均与结节性质相关(P<0.01)。ROC曲线显示,低剂量螺旋CT征象联合诊断结节性质的AUC最大,为0.907。结论良恶性SPN患者低剂量螺旋CT检查中结节形态、血管集束征、毛刺征、空气支气管征、棘状突起、胸膜凹陷征、分叶征、最长毛刺长度等征象及MDSCs存在明显差异,联合鉴别诊断结节性质具有较高价值。Objective To investigate the value of low-dose spiral CT signs combined with peripheral blood medullary suppressor cells(MDSCs)in the differential diagnosis of solitary pulmonary nodules(SPN)at initial diagnosis.Methods A total of 185 patients diagnosed with SPN from January 2019 to December 2021 were selected and underwent low-dose helical CT scans.The imaging characteristics of malignant and benign nodules were compared.Multivariate logistic regression was used to analyze the influencing factors of the nature of nodules.Receiver operating characteristic(ROC)and area under the ROC curve(AUC)were used to analyze the value of low-dose helical CT signs and MDSCs in differential diagnosis of nodules.Results The proportions of malignant nodules with irregular morphology,vascular bunching sign,burr sign,air bronchial sign,spinous process,pleural depression sign and lobulation sign were higher than those of benign nodules(P<0.01).The longest burr length of malignant nodules was shorter than that of benign nodules,and MDSCs were higher than those of benign nodules(P<0.01).Nodule morphology,vascular bunching sign,burr sign,air bronchial sign,spinous process,pleural depression sign,lobulation sign,the longest burr length and MDSCs were all correlated with nodule properties(P<0.01).ROC curve showed that the AUC of low-dose helical CT signs and MDSCs was the largest(0.907).Conclusion Signs such as nodule morphology,vascular bunching sign,burr sign,air bronchial sign,spinous process,pleural depression sign,lobulation sign,the longest burr length and MDSCs in benign and malignant SPN patients on low-dose spiral CT were significantly different,and the combined differential diagnosis of nodule nature was of high value.

关 键 词：孤立性肺结节 螺旋CT 低剂量 血管集束征 毛刺征 空气支气管征 胸膜凹陷征 外周血髓源性抑制细胞 

分 类 号：R734.2[医药卫生—肿瘤]