Solitary Pulmonary Nodule Diagnosis And Its Adverse Factors Of Mediastinal Lymph Node Metastasis

ObjectiveIn this study, we have established with 100 patients with solitary pulmonary nodules as sample,which diameter less than 2cm.We compared the clinical and pathological data of the sample before and after surgery.Identification and analysis of malignant and benign what influence of small lung cancer lymph node metastasis with clinical factorsMethods From tianjin chest hospital in February 2013 to December 2014 nodules after surgery < 2 cm of 100 patients with SPN, Collected within 1 week before the operation of CYFRA21-1 and CEA, preoperative CT and PET- CT data, Collection the pathological results and whether Mediastinal lymph node metastasis after surgery. Using SPSS 18.0 for statistical computing, to compared the clinical information in patients with difference between malignant and benign cases, in malignant cases analysis of the influencing factors of Mediastinal lymph node metastasis to explore which was independent factor of lymph node metastasis.Results(1) In 70 cases of isolated small lung cancer and 30 cases of benign pulmonary nodules, we have comparison of the patients’ gender, age, smoking history, nodules, nodule size, the serum Cyfra21-1 and fund no statistical correlations between malignant and benign nodules pathologic. Serum CEA level was statistically significant(P = 0.026)(2) CEA independently identify benign and malignancy sensitivity was 47.1%, with both serum Cyfra21-1 joint detection sensitivity was 64%, Sensitivity increased significantly.The CEA and CT combined identification between malignant and benign nodules. Sensitivity of 87%, early screening of SPN has important diagnostic significance.(3) In 70 cases of diameter <2cm isolation small lung cancer, there are 54 cases of adenocarcinoma, accounting for 77.1%, 16 cases of squamous cell carcinoma, accounting for 22.9%, including 18 cases of N1 existing lymph node metastasis in all sample accounting for 25.7%. Tumor size, CEA > 4.7 ng/m1, nodules solid component > 50%, tumor differentiation degree and the SUVmax is related factors of lymph node metastasis(P < 0.05).(4) According Logistic regression analysis nodules solid component is more than 50% are independent factors of lymph node metastasis(OR = 4.073 95% CI: 1.234 ~ 5.345, P <0.05). ROC curve AUC = 0.905Conclusion In solitary pulmonary nodules(tumors ≤2 cm) of diagnosis, sex, age, smoking history, tuberosity, nodule size and serum Cyfra21-1 of malignant or benign have no statistical difference. CEA in benign and malignant SPN had statistical differences, CEA and Cyfra21-1 combined detection can improve the sensitivity of diagnosis of SPN between malignant and benign.When CEA and CT joint to dentify benign and malignant nodules. The sensitivity becamed 87%, for the SPN screening has important clinical significance and solid components is greater than 50% were independent factors of malignant SPN lymph node metastasis.