A Retrospective Multivariate Analysis Of The Nature Of Solitary Pulmonary Nodules

ObjectiveWith the increasing number of lung cancer screening people,more and more people are detecting pulmonary nodules.It has always been a difficult problem for clinicians to accurately determine the nature of pulmonary nodules.Solitary pulmonary nodules are one type of pulmonary nodules.The purpose of this study is to identify the influencing factors that can help determine the nature of solitary pulmonary nodules by analyzing the clinical and imaging features of patients with solitary pulmonary nodules.MethodsData of 228 pathologically confirmed patients with solitary pulmonary nodules in the department of thoracic surgery of the first affiliated hospital of zhengzhou university from January 2016 to December 2018 were collected.The clinical and imaging data of patients with solitary pulmonary nodules were statistically analyzed.It includes age,sex,family history of cancer,smoking history,pathological results,density of nodules(solid nodule,mixed ground—class nodule,pure ground-class nodule),the size of nodules,the marginal appearance of a nodule(lobulation,spiculation,pleural effusion),location of nodules and bronchus encapsulated air sign.The data collected are statistically analyzed by the software of SPSS 21.ResultsThis study includes 228 patients with solitary pulmonary nodules.It includes 105males and 123 females.Their average age is 53.02±10.27.The mean diameter of SPN is 16.25±6.29mm.The mean diameter of benign nodules is 16.3±6.3mm.The mean diameter of malignant nodules is 17.1±6.1mm.There are 68 cases of benign nodules.It includes 37 cases of inflammatory pseudotumors,8 cases of tuberculomas,11 cases of pulmonary sclerosing hemangiomas,8 cases of hamartomas and 4 cases of fungal infections.There are 160 cases of malignant nodules.It includes 116 cases of adenocarcinomas,30 cases of squamous cell carcinomas,9 cases of Adenosquamous carcinomas,2 cases of large-cell anaplastic carcinomas,1 case of mucin epithelioid carcinoma and 2 cases of lymphoid epithelioid carcinomas.We analyzed the patient’s age,gender,family history of cancer,history of smoking,the size of nodules,spiculation,bronchus encapsulated air sign,pleural effusion,location of nodules,solid nodule,mixed ground—class nodule and pure ground-class nodule.The results show that the differences of age(t=-4.261,P<0.001),spiculation(X~2=13.525,P<0.001)and mixed ground—class nodules(X~2=5.032,P=0.025)in benign and malignant solitary pulmonary nodules are statistically significant.Multivariate regression analysis show that age(OR=1.077,P<0.001),spiculation(OR=3.220,P<0.001)and mixed ground—class nodules(OR=2.385,P=0.020)are independent risk factors for solitary pulmonary nodules.With the increase of age,the probability of SPN malignancy also increases.SPN with spiculation and mixed ground—class nodules imaging features is more likely to be malignant.ConclusionWith the improvement of people’s health awareness,more and more people find pulmonary nodules in physical examination.It is very important to judge the nature of nodules.In this study,the clinical and imaging characteristics of 228 patients with SPN were statistically analyzed.The conclusions are as follows.1.The probability of SPN malignancy increases with age.Age is an independent risk factor for malignant SPN.2.We used CT imaging features as the main basis for judging the nature of pulmonary nodules.In this study,spiculation and mixed ground—class nodules are independent risk factors for SPN malignancy.Great attention should be paid to SPN with spiculation and mixed ground—class nodules imaging features.