肺磨玻璃结节确诊早期浸润性腺癌的危险因素及预测模型构建  

Risk factors of lung GGN patients diagnosed with early invasive adenocarcinoma and prediction model construction

作　　者：宋晏 张高潮 张学敏 陈正福 付伟 SONG Yan;ZHANG Gaochao;ZHANG Xuemin;CHEN Zhengfu;FU Wei(Department of Nuclear Medicine,Hanzhong 3201 Hospital,Shaanxi Hanzhong 723000,China.)

机构地区：[1]汉中三二〇一医院核医学科,陕西汉中723000

出　　处：《现代肿瘤医学》2024年第6期1070-1074,共5页Journal of Modern Oncology

摘　　要：目的:探讨肺磨玻璃结节(ground glass nodules,GGN)确诊早期浸润性腺癌危险因素并构建预测模型,旨在为浸润性肺腺癌早期鉴别诊断及治疗方案制定提供更多参考。方法:回顾性分析2017年01月至2023年01月于我院诊治肺GGN患者共171例194个结节临床资料,根据术后病理组织学检查是否为浸润性肺腺癌分为浸润组(158个)和非浸润组(36个);比较两组临床病理及影像学特征资料;采用单因素和多因素法评估肺GGN确诊早期浸润性腺癌独立危险因素,肺GGN确诊早期浸润性腺癌风险预测模型构建及效能分析。结果:171例194个结节经术后病理组织学检查确诊为浸润性肺腺癌结节共158个,占比为81.44%。两组合并胸膜凹陷征比例、结节实性成分比例、SUV指数比较差异有统计学意义(P<0.05);两组其他临床病理及影像学特征资料比较差异无统计学意义(P>0.05)。多因素分析结果显示,合并胸膜凹陷征、结节实性成分比例及SUV指数均是肺GGN确诊早期浸润性腺癌独立危险因素(P<0.05)。利用回归模型的独立影响因素以及P值预测概率对患者肺GGN确诊早期浸润性腺癌风险进行预测,约登指数分别为52.55%、94.13%、70.72%、96.66%。结论:肺GGN患者是否属于浸润性腺癌与是否合并胸膜凹陷征、结节实性成分比例及SUV指数关系密切;而基于上述指标构建预测模型能够准确指导浸润性肺腺癌早期鉴别诊断。Objective:To investigate the risk factors of lung GGN patients diagnosed with early invasive adenocarcinoma and construct prediction model to provide more reference for the early differential diagnosis and treatment of invasive lung adenocarcinoma.Methods:Clinical data of 171 patients with lung GGN for 194 nodules were retrospectively analyzed in the period from January 2017 to January 2023.All patients were divided into invasion group(158 nodules)and non-invasion group(36 nodules)according to pathological diagnosed results of invasive lung adenocarcinoma.The clinicopathological and imaging characteristics of 2 groups were compared and the independent risk factors for early invasive adenocarcinoma diagnosed by lung GGN were evaluated by univariate factor and multivariate factor method.Construction and efficacy analysis of risk prediction model for early invasive adenocarcinoma diagnosed with lung GGN were performed.Results:A total of 158 nodules(81.44%)of 194 nodules in 171 cases were confirmed as infiltrating lung adenocarcinoma by histopathological examination.There were significant differences in the proportion of pleural depression sign,proportion of solid nodules and SUV index between the two combinations(P<0.05).There was no significant difference in other clinicopathological and imaging characteristics between the two groups(P>0.05).The results of multi-factor analysis showed that the combination of pleural depression sign,the proportion of solid nodular component and SUV index were independent risk factors for the diagnosis of early invasive adenocarcinoma of lung GGN(P<0.05).Independent influencing factors of regression model and P-value prediction probability were used to predict the risk of early invasive adenocarcinoma diagnosed by lung GGN.The Yoden index was 52.55%,94.13%,70.72%and 96.66%,respectively.Conclusion:The invasive adenocarcinoma of lung GGN was closely related to pleural depression,the proportion of solid nodular components and SUV index and the prediction model based on the above indexes

关 键 词：磨玻璃结节 肺腺癌 浸润性癌 PET/CT 模型 

分 类 号：R734.2[医药卫生—肿瘤]