The Value Of Preoperative CT-guided Hook-wire Localization Of Small Pulmonary Nodules In Video-assisted Thoracoscopic Surgery

Obje ctive：To e va lua te the va lue o f Preoperative CT-guided Hook-wirelocalizatio n of small pulmonary nodules (SPNs) in video-assistedthoracoscopic resection (VATS) in a consecutive series of8patients. Andto analyze risk factors of maligna nc y in patients with small pulmo na rynodules using chi-square test and multiva riate logistic regression．M e thods:From May2011to March2014， a total of199patients with266SPNs in the Frist Affiliated Hospita l of Dalia n Medical Univers ity whohad undergone CT-guided Hook-wire localiza tin before VATS were studiedretrospective ly. Statistic s the localiza tio n achieve me nt ratio, mean time oflocalizatio n, complic atio n rate were assessed． Chi-sq uare test wasperformed to analyze risk factors includ ing patient gender， age， type ofground-gla ss opacity， d ia mete r， form， ce nter high density， lob ula tio n，sp ic ula tio n，vo c ule s ign，a ir bro nc ho gra m s ign，p le ura l inde nta tio n，b loodvessels through， vas c ularco nverge nces ign． Indepe nde nt predictors ofmaligna nc y were screened with multivaria te logistic regressio n analys is.Re s ults:Chi-square test showed that there was statistica l differe nc e inthe type o f gro und-gla ss opac ity (P<0.001)，d ia meter (P<0.001)，c e nte r high density (P<0.001) and blood vessels through (P<0.001) between benign andmaligna nt small pulmo nary nodule groups. Multivariate logistic regressio nana lys is s ho wed that gro und-glas s o pac ity (O R=1.646，P=0.013),，d ia me ter(OR=4.220， P=0.001)， center high density (OR=12.414， P=0.018) andb lood vess e ls thro ugh (OR=3.936， P<0.001) we re indep e nde nt p red icto rsof maligna nc y in patients with small pulmo nary nodules．Co nc lus io ns： Preope rative C T-guided hook-wire loca liza tio n o f SPNsin VATS can decrease the time of operation， Impro ve the lesion detectionrate， having great value in clinica l promotio n． The type of ground-gla ssopac ity(p GGO、mGGO、So lid nod ules)，d ia meter，ce nter high d e ns ity a ndblood vessles through are independe nt predictors of maligna nc y in patientswith small pulmo nary nodules， ha ving important clinica l significa nce todiffere ntiate pulmona ry nodules benign or maligna nt.