Evaluation Of The Value Of CT Combined With PLT,D-dimer,FIB And Tumor Markers In The Diagnosis Of Benign And Malignant Pulmonary Nodules

Objective:We analyzed the clinical data and CT imaging features of patients with pulmonary nodules,and compared the diagnostic value of CT,platelets(Platelet,PLT),Ddimer(D-D),fibrinogen(FIB),tumor markers and combined tests in the benign and malignant nature of pulmonary nodules.The aim is to improve the accuracy of diagnosing the nature of pulmonary nodules,to assist clinicians in better diagnosing the nature of pulmonary nodules,and to provide the best treatment recommendations for patients.Methods:Patients with pulmonary nodules suggested by chest CT performed at the Department of Radiology of the Affiliated Hospital of Yan’an University from January2016 to December 2020 and treated by surgery in the Department of Thoracic Surgery of our hospital with pathology reports were collected.The patients were divided into benign and malignant groups according to the pathology report results,and the pathology results,clinical data(gender,age,symptoms,history of chest disease,smoking history,and family history of tumor),chest CT imaging features(diameter,location,lobar sign,burr sign,etc.),PLT,D-D,FIB,and tumor markers were recorded.The clinical data and CT imaging features of the two groups were analyzed,and the accuracy of CT,PLT,D-D,FIB,tumor markers,and the nature of the combined examination in diagnosing pulmonary nodules was compared between the two groups.Results:1.76 patients with pulmonary nodules,23 cases in the benign group and 53 cases in the malignant group.Among them,the benign group had the largest proportion of pulmonary tuberculosis(39.1%)and the malignant group had the largest proportion of pulmonary adenocarcinoma(86.8%).2.Comparison of clinical data: there were 11 male and 12 female cases in the benign group,with a mean age of 51.13±11.129 years;there were 21 male and 32 female cases in the malignant group,with a mean age of 57.68±11.014 years.The difference in age between the two groups was statistically significant(P=0.020),and the mean age of patients in the malignant group was considered greater than that in the benign group.The differences in gender,symptoms,history of chest disease,smoking history,and family history of tumor between the two groups were not statistically significant.3.Chest CT imaging features: there were statistically significant differences in lobar sign,burr sign,pleural depression sign,calcification,vascular cluster sign,and nodule density between the two groups(P<0.05),while there were no statistically significant differences in diameter,shape,location,border,vacuole sign,bronchial truncation sign,and bronchial air sign.4.The differences in the positive rates of CT,coagulation indexes(PLT,D-D,FIB),tumor markers in parallel,CT combined with coagulation indexes,CT combined with tumor markers,CT combined with coagulation indexes and tumor markers between the two groups were statistically significant(P<0.05),and the positive rate of examination in the malignant group was considered higher than that in the benign group.The differences in the positive rates of PLT,D-D,FIB,and tumor markers between the two groups were not statistically significant.5.When CT combined with coagulation indexes and tumor markers were used together to diagnose the nature of pulmonary nodules,the diagnostic accuracy was the highest and the diagnostic value was the greatest.Conclusion:1.Benign pulmonary nodules are mainly tuberculosis and malignant pulmonary nodules are mainly adenocarcinoma of the lung.2.When diagnosing the nature of pulmonary nodules,imaging physicians should take note of the patient’s age and read the films to carefully observe the lobar sign,burr sign,pleural depression sign,calcification,vascular set sign,and nodule density,which have certain clinical significance in determining the nature of pulmonary nodules.3.The diagnosis of the nature of pulmonary nodules is not only dependent on chest CT images,but also should pay attention to the value of coagulation indexes and tumor markers in the diagnosis of the nature of pulmonary nodules.CT combined with coagulation indexes and tumor markers in the diagnosis of pulmonary nodules can improve the accuracy of diagnostic results.