Establishment Of Lung Cancer Screening Scoring Model In Elderly Patients With Chronic Obstructive Pulmonary Disease And Study Of Related Serological Markers

Background:Chronic obstructive pulmonary disease(COPD)often accompanied by complications.The incidence of COPD combined with lung cancer is on the rise in many complications,and the incidence is higher in the elderly.Early symptoms of lung cancer will be masked by COPD symptoms,so it is easy to miss diagnosis,and it is often found in advanced lung cancer with poor prognosis.Low-dose CT is an effective method for screening COPD complicated with lung cancer,but it is not clear which people should be screened in time.This study will establish a lung cancer screening scoring model for elderly COPD patients,and carry out early identification of elderly COPD patients with high-risk lung cancer,and relevant serological markers will be studied to explore the significance of serum markers in COPD patients with high risk of lung cancer.Objective:To explore the establishment of lung cancer screening score prediction model and the level of relevant serological markers in elderly COPD patients,to improve the early identification of COPD high-risk lung cancer patients in geriatric clinical work.Methods:The general data and case data of COPD patients aged ≥ 60 years and first diagnosed with COPD complicated with lung cancer in our hospital from September2018 to September 2020 were retrospectively analyzed,including age,body mass index(BMI),whether to give up smoking,smoking index,emphysema,lung nodules,whether regular inhaled corticosteroids(ICS),disease duration and related serological markers,etc.SPSS26.0 statistical software was used for statistical analysis of the above results.Results:1.General information: There were 109 subjects who conform to the inclusion and exclusion criteria.The diagnostic criteria for COPD were based on the "Guidelines for Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease" issued by the Chinese Society of Respiratory Medicine,and other cancers were excluded.The diagnosis of lung cancer was pathologically confirmed.Among the 55 COPD patients with lung cancer,the mean age was(72.60±6.91)years old,including 5 females and 50 males.The mean age of 54 COPD patients was(70.54±7.49)years old,including 10 females and 44 males.There was no significant difference in general data between groups(P > 0.05).2.Establishment and comparison of screening scoring model: Each patient was assigned 1 point according to age ≥73 years old,1 point according to smoking index≥1100,2 points for disease duration ≥23 years,and 3 points for emphysema.0-3 was classified as low risk and 4-7 as high risk.A 7-point screening prediction model was established for each patient.High-risk group and low-risk group separated from subjects according to 7-point screening prediction model,and the difference was statistically significant(P < 0.01).3.Comparison of related serological markers: there were no significant differences in peripheral blood white blood cell count,neutrophil count,platelet count,mean platelet volume,fibrinogen count and bilirubin between the patients with COPD combined with lung cancer and the patients with COPD alone(P > 0.05).The differences in NLR,PLR and lymphocyte count were statistically significant.(P < 0.05)Conclusion:The 7-point screening scoring model established in this study can be used for early identification of high-risk groups with COPD complicated with lung cancer,and the study found that the level of lymphocytes in COPD patients with lung cancer decreased,while the level of NLR and PLR increased.It is of significance to further explore the serological markers of COPD with lung cancer in the elderly.