Analysis Of Risk Factors Associated With Early Lung Adenocarcinoma Manifested As Solitary Pulmonary Nodule

Objective:To investigate the risk factors of primary early lung adenocarcinoma in patients with solitary pulmonary nodule from the perspective of clinical history of patients,and provide a reference for the detection of solitary pulmonary nodule patients to assess their risk of primary early lung adenocarcinoma.Methods:Patients from the thoracic surgery of Dalian central hospital from September 2016 to January 2019 who were confirmed as primary early lung adenocarcinoma by surgery and pathology after finding solitary pulmonary nodule on chest CT were collected as the case group.In addition,patients were collected as control group from the thoracic surgery of Dalian central hospital from September 2016 to January 2019 who were confirmed as benign lesions by surgery and pathology after finding solitary pulmonary nodule on chest CT.Choose a total of 12 factors include age?gender?smoking history?smoking index?lung related clinical symptoms?history of basic lung disease?family history of lung cancer?history of malignant tumors in other partsof the body?history of autoimmune diseases?body mass Index(BMI)?history of combined basic diseases and course of disease.SPSS24.0 statistical software was used for statistical analysis,The measurement data in single factor analysis is expressed in the form of mean±standard deviation,and the difference comparison between the measurement data sets conforming to the normal distribution and homogeneity of variance was performed by t test,while the data not conforming to the normal distribution or homogeneity of variance was performed by rank sum test.The chi-square test was used for counting data.In multi-factor analysis,removing the variables without statistical significance in single factor analysis(P>0.05),and variables with P<0.05were selected to be included in the binary classification non-conditional multivariate Logistic regression analysis model for multivariate analysis.Results:A total of 330 patients were enrolled in the study.Among the 262 patients who were diagnosed as primary early lung adenocarcinoma by surgery and pathology after finding solitary pulmonary nodule on chest CT,there were 87 cases(33.2%)of males and 175 cases(66.8%)of females,their age from 28 to 82,with a median age of61.Among the 68 patients in the group of benign pulmonary nodules confirmed by surgery and pathology after finding solitary pulmonary nodule on chest CT at the same time,there were 35 males(51.5%)and 33 females(48.5%),their age from 23 to 78,with a median age of 60.Through the single factor analysis found that the gender of the patients between the two groups(?~2=7.729,P=0.005)?age(t=2.580,P=0.010)?smoking history(?~2=6.336,P=0.012)?history of diabetes mellitus(?~2=7.705,P=0.006),they have statistically significant(P?0.05).Pulmonary related clinical symptoms?smoking index?BMI,history of malignant tumors in other parts of the body?family history of lung cancer?history of pulmonary basic diseases?history of autoimmune diseases and hypertension haven't statistically significant(P>0.05).Multivariate logistic regression analysis showed that Gender(OR value=1.929,P=0.026),age(OR value=1.051,P=0.001)and history of diabetes mellitus(OR value=2.703,P=0.009)have statistically significant,indicating that they were independent risk factors for early lung adenocarcinoma.Conclusion:It is suggested that the patients with solitary pulmonary nodule who are female,older age and with no diabetes mellitus are at higher risk of early lung adenocarcinoma.Therefore,patients with solitary pulmonary nodule with these risk factors should be given high priority and diagnose as early as possible.