Analysis Of The Factors Influencing The Benign And Malignant Of Solitary Mixed Ground Glass Nodule

Objectives Through retrospective analysis of the basic clinical data,imaging data,laboratory data and pathological diagnosis data of patients with solitary mixed pulmonary ground glass nodule treated by thoracic surgery,this study aims to identify the factors influencing the benign and malignant of solitary mixed pulmonary ground glass nodule.This study could be helpful for the evaluation of benign and malignant,as well as clinical decision-making of solitary mixed pulmonary ground glass nodules.Methods The medical records of 150 patients with solitary mixed pulmonary ground glass nodule treated by thoracic surgery from August 2015 to August 2019 in Tangshan people’s Hospital Affiliated to North China University of technology were collected.According to the postoperative pathological diagnosis,the patients were divided into benign/Atypical adenocarcinoma hyperplasia(AAH)lesions group and malignant lesions group.The basic clinical data(sex,age,smoking history,family history of malignant tumor,respiratory symptoms),imaging data(nodule shape,nodule interface,lobulation sign,spiculation sign,vascular cluster sign,pleural indentation sign,bronchial inflatability sign,vacuole sign,nodule diameter,proportion of solid components in nodule,solid component shape,solid component location and solid formation)and laboratory data(lung tumor markers: neuron-specific enolase,pro gastrin releasing peptide,carcinoembryonic antigen,cytokeratin fragment 19,squamous cell carcinoma antigen)of the two groups were analyzed by single factor analysis,and the indexes with statistical significance were selected to distinguish the benign and malignant of solitary mixed lung ground glass nodules.Further multivariate analysis was conducted to identify the benign and malignant features of solitary mixed lung ground glass nodules after single factor analysis.The significant indexes of the two groups were used as independent variables,and malignant solitary mixed lung ground glass nodules were used as dependent variables to make the receiver operating characteristic(ROC).The counting data was expressed by composition ratio or rate,and the accurate Fisher test was used for statistical analysis.The measurement data was expressed by mean ± standard deviation,and the group t test was used for statistical analysis.Multivariate analysis was performed with binary Logistic regression analysis.Results 1 Among the 150 cases of solitary mixed lung ground glass nodules,there were 29 cases in benign/AAH group and 121 cases in malignant group,the malignant rate was 80.67%.In benign/AAH lesions,there were 16 cases of atypical adenocarcinoma hyperplasia,5 cases of local inflammation,4 cases of focal fibrous hyperplasia,2 cases of hamartoma and 2 cases of pulmonary tuberculosis.There were 20 cases of adenocarcinoma in situ,41 cases of minimally invasive adenocarcinoma and 60 cases of invasive adenocarcinoma.2 Single factor analysis showed that the lobulation sign,spiculation sign,vascular cluster sign,pleural indentation sign,vacuole sign,nodule diameter,solid component proportion and carcinoembryonic antigen level Statistical significance in malignant group were significantly higher than those in benign/AAH group(χ~2 = 8.114,P = 0.004;χ~2 = 6.542,P = 0.015;χ~2 = 4.579,P = 0.035;χ~2 = 4.158,P = 0.043;χ~2 = 4.188,P = 0.043;t =-4.790,P = 0.001;t =-2.005,P = 0.047;χ~2 = 4.158,P = 0.043,respectively).3 The significant indexes were included in binary Logistic multiple factor regression analysis.The results showed that lobulation sign,spiculation sign and nodule diameter were independent risk factors of malignant solitary mixed ground glass nodule.4 The results showed that the cut-off value of nodule diameter was 16.50 mm,AUC was 0.79,sensitivity was 71.12%,and specificity was 89.72%.Conclusions 1 The malignant rate of solitary mixed ground glass nodule is 80.67%.2 Lobulation sign,spiculation sign and nodule diameter are independent risk factors for malignant solitary mixed ground glass nodules.3 The cut-off value of 16.50 mm of nodule diameter has a certain predictive value for malignant solitary mixed ground glass nodule.Figure1;Table8;Reference 117...