Clinical Characteristics Of Solitary Pulmonary Ground Glass Opaciy(GGO) And Its Influencing Factors For Benign And Malignant Tumors

Objective:Solitary pulmonary ground glass opacity may be the early stage of lung cancer.The purpose of this study was to predict the independent risk factors for benign and malignant solitary pulmonary ground glass opacity by retrospective analysis of the general clinical features,imaging features and histopathological classification of patients with solitary ground glass opacity treated by Department of Thoracic Surgery,China-Japan Union Hospital of Jilin University.Materials and Methods:Clinical data of 134 patients with solitary pulmonary ground glass opacity(GGO)were collected from January 2017 to December 2018 in the Department of Thoracic Surgery,China-Japan Union Hospital of Jilin University.According to the histopathological types,the patients were divided into benign/AAH group and malignant group,including 112 cases of malignant group,including 109 cases of adenocarcinoma,2 cases of squamous cell carcinoma and 1 case of small cell lung cancer;22 cases of benign/AAH group,including 11 cases of atypical adenomatous hyperplasia(AAH),3 cases of tuberculosis,2 cases of lymphoid tissue hyperplasia,4 cases of focal inflammation,1 case of pulmonary hamartoma and 1 case of organic pneumonia.The general clinical features(sex,age,smoking history,drinking history,family history of malignant tumors),imaging features(nodule diameter,nodule location,nodule type,vascular cluster pleural indentation sign,vacuole sign,lobulation sign,bronchial inflatability sign)and histopathological characteristics of benign/AAH group and malignant group were compared and analyzed.Results:Univariate analysis showed that age,nodule diameter,nodule type,vascular cluster sign,pleural indentation sign,vacuole sign and lobulation sign of the two groups had statistical significance(t=-2.674,P=0.013;t=-3.221,P=0.002;χ2=6.031,P=0.017;χ2=5.417,P=0.021;χ2=9.552,P=0.001;χ2=5.312,P=0.027;χ2=5.110,P=0.023).The proportion of age,nodule diameter,nodule type,vascular cluster sign,pleural indentation sign,vacuole sign and lobulation sign in benign/AAH group was lower than that in malignant group.There were no statistical differences in gender,smoking history,drinking history,family history of malignant tumors,nodule location,nodule shape and bronchial inflatability sign between the two groups.Then,significant variables(age,nodule diameter,nodule type,vascular cluster sign,pleural indentation sign,vacuole sign and lobulation sign)were included in multivariate regression analysis.Unconditional binary logistic regression analysis showed that nodule diameter,vascular cluster sign,pleural indentation sign and lobulation sign were independent risk factors for malignant solitary pulmonary ground glass nodules.Age,nodule type and vacuole sign were not independent risk factors for predicting malignant solitary pulmonary ground glass nodules.Using ROC curve and nodule diameter as predictive index,malignant solitary pulmonary ground glass nodules were predicted.The results showed that the area under the curve was 0.726,the sensitivity was 83.58%,the specificity was 91.79%,and the Yoden index was 0.754.The results showed that the cut-off value of nodule diameter was 10.05 mm,which had a good predictive effect on malignant solitary ground glass nodules.There were 112 cases in malignant group,of which 97.32% were lung adenocarcinoma.Conclusion:(1)The size of nodules,vascular cluster sign,pleural indentation sign and lobulation sign are independent risk factors for the prediction of benign and malignant solitary pulmonary ground-glass nodules.(2)The cut-off value of nodule diameter is 10.05 mm,which has a good predictive effect on malignant solitary ground-glass nodules.When nodule diameter is greater than 10.05 mm,it should be highly suspected that it is malignant nodule.(3)The most common histopathological type of pulmonary ground glass nodules is adenocarcinoma.