Clinical Analysis Of 95 Patients With Solitary Pulmonary Nodule

Objective To investigate the clinical characteristics of solitary pulmonary nodule(SPN),application of CT,PET/CT,fiberbronchoscopy,percutaneous aspiration lung biopsy in the diagnosis of SPN and application of video assisted thoracoscopic sugery(VATS)in the diagnosis and treatment of SPN.Materials and methods Clinical data of patients with SPN from September 2005 to December 2007 were collected from Shandong Province Hospital.According to the result of pathology,the patients were divided into two groups,benigh and malignant group.Gender,age,smoking index,diameter of nodule,clinical manifestations were included.The accuracy of CT,PET/CT,fiberbronchoscopy, percutaneous aspiration lung biopsy and VATS in the diagnosis of SPN was further analyzed.Days in hospital were compared between VATS and thoracotomy and advantages of VATS in the treatment of SPN were analyzed.Results There are 53 cases in malignant group,which consists of 35 cases with adenocarcinoma,9 cases with adenosquamous cell carcinoma,7 cases with squamous cell carcinoma,2 cases with metastatic cancer.There are 42 cases in benign group, which consists of 5 cases with inflammatory pseudotumor,13 cases with hamartoma, 15 cases with tuberculoma,4 cases with sclerosing hemangioma,5 cases with lung cyst.There was significant difference between malignant group and benign group in age and diameter of nodule.There was no significant difference between malignant group and benign group in gender,smoking index and clinical manifestations. Sensitivity and specificity in the diagnosis of SPN for CT were 94.8%and 54.2%,for PET/CT were 85.7%and 66.7%.14 cases receiving fiberbronchoscopy were not given a clear diagnosis and no case received percutaneous aspiration lung biopsy. Sensitivity and specificity in the diagnosis of SPN for VATS were 100%.The average days in hospital of 35 cases with VATS were less than that of 60 cases with thoracotomy.All the operations were successfully accomplished and no complications or deaths occurred peri-operatively.Follow-up 4 to 30 months,the remaining patients survived except 6 cases of lost.Conclusions The incidence of malignant SPN increases with age and diameter of nodule.There is no obvious correlation between gender,smoking index,clinical manifestations and the incidence of malignant SPN.Specificity for CT and PET/CT in the diagnosis of SPN is poor,Sensitivity for fiberbronchoscopy and percutaneous aspiration lung biopsy in the diagnosis of SPN is poor.VATS can be used for the diagnosis and treatment of SPN and obtain a satisfactory prognosis.