摘要
目的通过单因素与多因素Logistic回归分析筛选出与恶性孤立性肺结节（SPN）相关的临床特征及影像学征象。方法回顾性收集2008年7月1日至2011年12月1日在南京军区福州总医院出院经病理确诊的SPN患者资料共223例。记录其性别、年龄、吸烟史、恶性肿瘤病史、结节部位、最大直径、密度、空泡、非良性钙化、分叶、毛刺、胸膜凹陷征、血管集束征、病理共14项临床资料，通过单因素分析及多因素Logistic回归分析筛选出恶性SPN的独立危险因素。结果单因素分析显示：患者性别、年龄、分布、最大直径、密度、钙化、分叶征、毛刺征、胸膜凹陷征在SPN良恶性中的差异有统计学意义。其中，患者为女性，年龄越大，且结节为上叶分布、部分实性，出现分叶征、毛刺征及胸膜凹陷征，则该结节倾向于恶性。下叶分布的实性结节，如合并有钙化灶，则良性可能性大。吸烟史、恶性肿瘤病史、空泡征、血管集束征在良恶性SPN中的差异无统计学意义。多因素Logistic回归分析结果显示：女性、分叶征及胸膜凹陷征是恶性SPN的独立危险因素，下叶分布、实性结节为独立保护性因素。结论对于SPN，女性、分叶征及胸膜凹陷征是恶性的独立危险因素，而下叶分布、实性结节则为独立保护性因素。
Objective To screen out the risk factors for malignant solitary pulmonary nodule through univariate and multivariate Logistic regression analysis. Methods The clinical data of 223 patients with SPN pathologically confirmed from July 1st 2008 to December 1st 2011 were collected. Clinical data included gender, age, smoking history, history of malignant tumor, location, diameter, density, vacuole sign, calcification, lohulation, spiculated sign, pleural indentation sign, vascular convergence sign, and pathological diagnosis. The independent risk factors of malignant SPN were estimated with single-factor analysis and multivariate analysis. Results Single-factor analysis showed that gender, age, location, diameter, density, calcification, lobulation, spiculation, pleural indentation sign significantly affected the judgment of SPN whether it was benign or malignant. Of the factors above,elder female patients,with a simi-solid nodule in upper side of lung, which appeared lobulation, spiculated sign, pleural indentation sign, might be apt to be malignant. A solid nodule in lower part of lung might be benign very likely,if combined with calcification. There was no statistical difference in smoking history, history of malignant tumor, vacuole sign, and vascular convergence sign between benign and malignant SPN. The multivariate analysis revealed that female, lobulation, and pleural indentation sign were the independent predictors of malignancy in patients with SPN, solid nodule and lower lobe location suggested to be benign. Conclusions As for SPN, female, lobulation, and pleural indentation sign are the independent predictors of malignancy in patients with SPN, meanwhile, lower lobe distribution and solid nodule suggest to be benign.
出处
《国际呼吸杂志》
2013年第12期915-917,共3页
International Journal of Respiration
