1.Plasm Metabolomics Study In Lung Cancer Screening And Differential Diagnosis 2.Imaging Features And Clinical Decision Analysis Of 110 Cases Of Intrapulmonary Lymph Nodes

Objectives:Early detection and diagnosis of lung cancer can effectively reduce the mortality rate of patients with lung cancer.Nowadays,there is a lack of satisfactory biomarkers in the screening and differential diagnosis of lung cancer,which affects the early diagnosis of lung cancer to some extent.Metabolomics is the qualitative and quantitative study of all low molecular metabolites in the body.Through the comparison of lung lesions and healthy people,the difference of low-molecular metabolites between them can be found.These metabolites have the potential to become lung cancer biomarkers.Methods:The medical documents and blood samples of patients with pulmonary nodules admitted to our department from February 1,2019 to May 31,2019 were collected.According to the postoperative pathological results,these patients were divided into three groups:pulmonary metastatic carcinoma(PMC),benign pulmonary nodules(BPN),and primary lung cancer(PLC).Besides,healthy people who have no pulmonary nodules were enrolled as healthy population group(HPG)during the same period.Half people of PLC and HPG were selected as the discovery set,and the other half as the validation set,by random sampling method.On the one hand,to study lung cancer screening in healthy people,four groups were compared as a whole and then three groups with different pulmonary lesions(PMC,BPN and PLC)were compared with HPG respectively.The significant low-molecular metabolites between groups could be found by multivariate statistical analysis method.And their discriminating ability was verified by ROC curve.On the other hand,the three pulmonary nodule groups were compared as a whole and in pairs.The main low-molecular metabolites were selected and their discriminating ability was verified.At last,six different metabolites from the discovery set were examined by ROC curve in the validation set.Results:There is no significant difference in the general conditions such as gender and age between the groups.In terms of lung cancer screening for healthy people,five different low-molecular metabolites were detected by comparison of four groups as a whole.They were decanoylcarnitine,y-glutamylphenylalanine,lysoPG(18:1),CMP-N-glycoloylneuraminate,and Meloside L.Four to six significant metabolites were selected by comparison of the three pulmonary lesion groups with healthy people,respectively.These metabolites all had good sensitivity and specificity.In terms of the differential diagnosis of pulmonary nodules,the significant low-molecular metabolites selected by the comparison of three groups as a whole were anabasine,octanoylcarnitine,2-methoxyestrone,retinol,decanoylcarnitine,calcitroic acid,glycogen and austalide L.Each pairwise comparison within the three pulmonary nodule groups all found three metabolites,whose discriminating ability were good.From the comparison of the testing set of PLC and HPG,six low-molecular metabolites were selected.Their AUC of ROC are all greater than 0.95 in the validation set.It indicates that these six substances have a strong ability to differentiate between primary lung cancer and healthy people.Conclusion:Through the research of plasm metabolomics,it is possible to effectively detect the changes in some low-molecular metabolites between primary lung cancer,pulmonary metastatic carcinoma,benign pulmonary nodule and healthy people.These significant metabolites have the potential to be biomarkers for screening and differential diagnosis of lung cancer.Objectives:Through the summary and analysis of large samples,the characteristic imaging manifestations of intrapulmonary lymph nodes(IPLNs)were quantified,and the corresponding rating tables were developed.These rating tables could be used to distinguish the intrapulmonary lymph nodes from primary lung cancer,so as to improve the diagnostic accuracy and help clinicians make correct judgments and decisions.Methods:A total of 82 patients with 110 IPLNs and 35 patients with 35 primary lung cancer lesions were collected from June 2017 to December 2018.All lesions were solid nodules of less than 12mm diameter which were confirmed by pathology.Observation indicators included location,size,shape,density,border and internal vacuole of nodules;linear high density shadow around the nodules,distance from the pleura,pleural indentation and so on.Results:There were statistically significant differences in the location,size,shape,internal vacuole of the nodules and distance from the pleura.The diagnostic scoring table of the nature of solid nodules and the malignant risk table were drawn.The nodule corresponding to Level A was most likely the primary lung cancer,and surgical resection was recommended.The nodule corresponding to Level C was most likely IPLN,and it was better to receive no treatment currently and watchful waiting.The positive predictive value was 81%(23/28),the negative predictive value was 97%(89/92),the sensitivity was 63%(23/35),and the specificity was 81%(89/1 10).Conclusion:For the pulmonary solid nodules with diameter less than 12mm and unknown nature,the evaluation in accordance with the score table and the risk level table of this study can be more accurate and faster than the original judgment,which will help clinicians in diagnosis and treatment decisions.