Risk Factor Analysis Of The Patients With Solitary Pulmonary Nodules And Patients Traditional Chinese Medicine Constitution Related Analysis

Objective To screen the clinical risk factors of lung cancer in the patients with solitary pulmonary nodules(SPN),and build the clinical prediction model to estimate the probability of malignancy.And investigate the distribution of prognostic factors in Chinese medicine constitution and analyze the relationship between Chinese medicine constitution and patient among cases with Solitary pulmonary nodule.Methods A retrospective cohort study in our institution included 136 patients with definite pathological diagnosis of solitary pulmonary nodules from Jan 2012 to Sep 2009.Clinical data included age,gender,course of disease,symptoms,history and quantity of smoking history,history of tumor,family history of tumor,site,diameter,calcification,speculation,border,lobulation,traction of pleural,vascular convergence sign,and cavity.The independent predictors of malignancy were estimated with multivariate analysis,then the clinical prediction model was built.Result Among 136 patients,there had 103(75.7%)cases of lung cancer,and 33(24.3%)benign lesions.(1)Single factor analysis showed that gender,age,CEA,lobulation,speculation,pleural indentation were significantly affected the judgment of SPN whether it was benign or malignant(P<0.05).(2)The multivariate analysis revealed that gender,age,diameter and malignant,spiculation and pleural indentation sign were independent risk factors of lung cancer in the patients with SPN(P<0.05).(3)The mathematical prediction model to estimate the probability of malignancy was:Logit(P)=e/(1+ez),Z=z=-6.632+gender*0.978+age*0.062+diameter*0.208+ spiculation*1.222+pleural indentation sign*1.306,and e was natural logarithm.(4)Qi-deficiency type between the SPN patients had statistical significance(P<0.05)。Conclusion Patient gender,age,nodule diameter,speculation and pleural indentation sign are independent predictors of malignancy in patients with small pulmonary nodules.The base mathematical prediction model can estimate the probability of malignancy for patients with small pulmonary nodules.Benign or malignant Solitary pulmonary nodule patients may relevant with the Chinese medical certificate type.