亚厘米肺小结节良恶性结节检出情况及患者预后的影响因素分析  

Analysis of the detection of benign and malignant sub-centimeter pulmonary nodules and the influencing factors of prognosis

作　　者：龚梅[1] 郑东英[1] 姜芳芳 刘清毅[1] 邓日强[1] GONG Mei;ZHENG Dongying;JIANG Fangfang;LIU Qingyi;DENG Riqiang(Department of Respiratory and Critical Care Medicine,YueBei Guangdong People's Hospital,Shaoguan,Guangdong,512000,China)

机构地区：[1]粤北人民医院呼吸与危重症医学科,广东韶关512000

出　　处：《当代医学》2024年第24期79-83,共5页Contemporary Medicine

基　　金：韶关市卫生健康局科研计划项目(Y21069)。

摘　　要：目的探讨亚厘米肺小结节中良恶性结节的检出情况及患者预后影响因素。方法回顾性分析2017年1月至2019年12月于粤北人民医院就诊的3441例亚厘米肺小结节患者的临床资料,均实施CT检查及病理诊断。分析良恶亚厘米肺小结节检出情况,分析良恶性亚厘米肺小结节的病理类型、临床及影像学特征;分析恶性亚厘米肺小结节随访情况及预后,并采用多因素Logistic回归分析恶性亚厘米肺小结节患者预后不良的影响因素。结果3441例亚厘米肺小结节患者中,CT检查检出良性2104例,检出率为61.15%,恶性1337例,检出率为38.85%。良性结节与恶性结节患者结节直径、结节密度、结节数量、结节位置、结节部位比较差异有统计学意义(P<0.05)。良性结节与恶性结节患者血管集束征及毛刺情况比较差异有统计学意义(P<0.05)。随访1年,共68例恶性亚厘米小结节患者完成随访,其中死亡31例,存活37例;死亡与存活患者结节直径、既往肿瘤史、结节密度、结节数量及毛刺情况比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,结节直径较大、结节密度(纯磨玻璃结节)、结节多发为恶性亚厘米肺小结节患者死亡的独立危险因素(P<0.05)。结论在亚厘米肺小结节中恶性结节检出率相对较低,良性结节中可见部分高危CT征象,临床应加强鉴别,还应定期对患者进行体检,以掌握结节变化情况,为临床制订个体化的干预方案提供指导与参考。Objective To investigate the detection of malignant subcentimeter pulmonary nodules and the prognostic factors.Methods The clinical data of 3441 patients with subcm pulmonary nodules who were treated in YueBei Guangdong People's Hospital from January 2017 to December 2019 were retrospectively analyzed.The detection of benign and malignant sub-centimeter pulmonary nodules was analyzed,the pathological types,clinical and imaging features of benign and malignant sub-centimeter pulmonary nodules were analyzed,and the follow-up and prognosis of patients with malignant sub-centimeter pulmonary nodules were analyzed,and the influencing factors of poor prognosis were analyzed by multivariate Logistic regression.Results Among 3441 patients with sub-centimeter pulmonary nodules,CT examination detected 2104 benign cases,the detection rate was 61.15%,and 1337 cases of malignant,the detection rate was 38.85%.There were significant differences in nodule diameter,nodule density,nodule number,nodule location and nodule location between paitents with benign nodules and malignant nodules(P<0.05).There were significant differences in vascular convergence sign and burr between paitents with benign nodules and malignant nodules(P<0.05).During the 1-year follow-up,a total of 68 patients with malignant and cm nodules were complete follow-up,including 31 cases died,37 cases of survival.There were significant differences in nodule diameter,previous tumor history,nodule density,nodule number and spiculation between dead and survival patients(P<0.05).Multivariate Logistic regression analysis showed that larger nodule diameter,nodule density(pure ground glass nodule)and multiple nodules were independent risk factors for death in patients with malignant sub-centimeter pulmonary nodules(P<0.05).Conclusion The detection rate of malignant nodules in subcentimeter pulmonary nodules is relatively low,and some high-risk CT signs can be seen in benign nodules.Clinical identification should be strengthened,and regular physical examination should be

关 键 词：亚厘米肺小结节 良性结节 恶性结节 预后影响因素 

分 类 号：R73[医药卫生—肿瘤]