肺结节患者的临床特征在判断良恶性中的意义  

Clinical features of patients with pulmonary nodules and their significance in judging benign and malignant

作　　者：老奋坚 王伟[2] 谭桂燕 周承志[4] 何梦璋[1] Fenjian Lao;Wei Wang;Guiyan Tan;Chengzhi Zhou;Mengzhang He(Department of respiratory medicine,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou Guandong 511447,China;Department of thoracic surgery,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou Guandong 510260,China;Faculty of Graduate Studies,Guangzhou Medical University,Guangzhou Guandong 511436,China;Department of respiratory medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou Guandong 510120,China)

机构地区：[1]广州医科大学附属第二医院番禺院区呼吸科,广东广州511447 [2]广州医科大学附属第二医院昌岗院区胸外科,广东广州510260 [3]广州医科大学研究生学院,广东广州511436 [4]广州医科大学附属第一医院呼吸科,广东广州510120

出　　处：《中华临床实验室管理电子杂志》2022年第3期147-152,共6页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

摘　　要：目的探究肺结节特点与其病理结果的相关性,分析患者临床特征(临床因素、检验结果、胸部CT影像特征)对判断肺结节良恶性的临床意义。方法回顾性分析147例肺结节患者,根据病理活检结果分为良性组39例,恶性组108例。比较两组患者的一般情况(性别、年龄、吸烟史、恶性肿瘤家族史)、肺癌4项[癌胚抗原(CEA)、鳞状上皮细胞抗原(SCCAg)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(Cyfra21-1)]以及高分辨率CT征象,评估差异有统计学意义的因素在鉴别良恶性肺结节中的效能。结果两组患者在性别、吸烟史、4个肺癌指标(CEA、SCCAg、NSE、Cyfra21-1)、结节大小、结节边缘、毛刺征的比较,差异均无统计学意义(均P>0.05),在年龄、恶性肿瘤家族史、结节形态、分叶征、空泡征、胸膜牵拉征、血管集束征的比较,差异均有统计学意义(均P<0.05)。在高分辨率CT征象中,分叶征对判断肺结节良恶性的效能最高,敏感度达79.6%。Logistic线性回归分析显示磨玻璃结节、分叶征、空泡征都是恶性的危险因素(均P<0.05)。结论患者的年龄、恶性肿瘤家族史、结节形态(磨玻璃结节)、分叶征、空泡征、胸膜牵拉征、血管集束征对鉴别肺结节良恶性有一定的参考意义。Objective To explore the correlation between the characteristics of pulmonary nodules and their pathological results,and to speculate the clinical significance in judging the benign and malignant of pulmonary nodules.Methods A retrospective analysis of 147 patients with pulmonary nodules,including 39 cases benign(benign group)and 108 cases malignant(malignant group).To evaluate the effectiveness of statistically significant factors in differentiating the benign and malignant pulmonary nodules,the general conditions(age,gender,smoking history)、tumor indexes(CEA,SCCAg,NSE,CYFRA21-1)and high-resolution CT signs between the groups were compared.Results There was no significant difference in gender,smoking history,four lung cancer indexes,nodule size,nodule edge and burr sign between the groups(all P>0.05),but there were significant differences in age,family history of malignant tumor,nodule morphology,lobulation sign,vacuole sign and pleural traction sign(all P<0.05).The lobulation sign was the most effective factor in judging the benign and malignant of pulmonary nodules among the high-resolution CT signs,with a sensitivity of 79.6%.Logistic linear regression analysis showed that ground-glass nodule,lobulation and vacuole were all risk factors for malignancy(all P<0.05).Conclusion Age,family history of malignant tumor,nodule shape,lobulation sign,vacuole sign and pleural traction sign have certain reference significance in differentiating benign and malignant pulmonary nodules.

关 键 词：肺结节 肺癌 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]