Clinical Study On The Prediction Of Risk Factors For Pulmonary Ground Glass Nodules

Objective:By collecting the shandong university qilu hospital thoracic surgery by thoracoscope surgery treatment of pulmonary grinding glass nodules(GGO,Ground Grass Opacity)in patients with general clinical characteristics(gender,age,smoking history,etc.),imaging characteristics(position of GGO,size of GGO,type of GGO and burr etc.)and histopathological results,analysis the clinical characteristics of pulmonary grinding glass nodules,imaging features and histopathological results,the relationship between the prediction of malignant lung nodules of risk factors for grinding glass,for the diagnosis,differential and treatment of pulmonary grinding glass nodules provide more effective and scientific basisMaterials and methods:Collection of clinical data of 202 patients who visited the Department of Thoracic Surgery,Qilu Hospital,Shandong University from February 2019 to July 2019:Ground Grass Opacity(including clinical characteristics,imaging characteristics and histomopathological findings).According to histopathological types,it was divided into non-malignant(benign and atypical adenomatoid hyperplasia)group and malignant group,non-malignant(benign and atypical adenomatoid hyperplasia)group with 22 cases and malignant group with 180 cases.Non-malignant(benign and Atypical Adenomatous Hyperplasia)groups include:2 cases of Atypical Adenomatous Hyperplasia(AAH,invasive Adenomatous Hyperplasia),7 cases of inflammatory pseudotumor,5 cases of fibrous connective tissue Hyperplasia,1 case of leiomyoma,5 cases of hamartoma,2 cases of invasive pneumonia.The incisal margin is all negative.The malignant group included 158 adenocarcinomas,18 squamous cell carcinomas and 4 small cell carcinomas.Comparative analysis of malignant(benign and atypical adenomatous hyperplasia)group and the general clinical features of patients with malignant group(including gender,age,smoking history and family history of malignant tumor patients with),imaging characteristics(including:grinding glass glass,lung nodules position in lung nodule size,pulmonary nodule type grinding glass,burr sign,pleural pull),cavitation sign,blood vessels,cluster sign,points Ye Zheng and swollen lymph nodes),histopathological characteristics(including pathological classification,invasion and pleura and positive lymph nodes).Statistics:The collected data were analyzed by SPSS 22.0 data analysis software.The age of the patients was expressed as mean ± standard deviation.Comparison between the non-malignant(benign and atypical adenomatoid hyperplasia)group and the malignant group was performed by independent sample T-test.Gender,age,smoking history,family history of malignant tumor,pulmonary nodule size glass,lung nodules position grinding glass,pulmonary nodule type grinding glass,burr sign,pleural pull),cavitation sign,blood vessels,cluster sign,points Ye Zheng and lymph node enlargement,adoption or forming than said,comparison between the two groups by chi-square test.The relationship between pleural traction and pathologic invasion and between lymph node enlargement and pathologic lymph node positivity was expressed by composition ratio.Select variables(P<0.05).These variables were summarized.Multivariate analysis was carried out using the unqualified dichotomous logistic regression analysis to further predict the independent risk factors of the good or malignant nature of GGO,Ground Grass Opacity.Screening for independent risk factors(P<0.05).ROC curve was used to predict the diameter of malignant pulmonary ground glass nodules by taking these risk factors as predictive indexes.Results:A total of 180 patients were in the malignant group,including 158 adenocarcinomas,18 squamous cell carcinomas and 4 small cell carcinomas.Nonmalignant(benign and Atypical Adenomatous Hyperplasia)group included 7 cases of inflammatory pseudotumor,5 cases of fibrous connective tissue Hyperplasia,1 case of leiomyoma,5 cases of hamartoma,2 cases of organizing pneumonia,2 cases of Atypical Adenomatous Hyperplasia(AAH,Adenomatous incisal margin).In the non-malignant(benign and atypical adenomatoid hyperplasia)group,patients' age,smoking history,size of ground glass nodules,types of ground glass nodules,burr sign,vascular cluster sign,foliation sign,pleural traction sign and vacuole sign were all lower than those in the malignant group.Univariate analysis revealed gender of non-malignant(benign and atypical adenomatoid hyperplasia)and malignant(2=0.238,P=0.339>Smoking history(2=0.320,P=0.337>Family history of malignant tumor(2=3.461,P=0.174>0.05),nodule location(2=0.640,P=0.959>0.05)No statistical difference was found after statistical analysis.Age(T=-1.623,P=0.016<0.05),nodule size(2=5.968,P=0.014<(2=3.352,P=0.039<0.05),burr sign(2=5.628,P=0.034<(2=4.003,P=0.018<(2=6.994,P=0.025<0.05),pleural traction sign(2=6.526,P=0.028<0.05),vacuolar sign(2=5.647,P=0.046<0.05),lymph node enlargement(2=3.875,P=0.034<0.05)Statistically significant.Then,the significant variables of univariate analysis were included into the multivariate regression analysis.Logistic regression analysis showed that the lung ground glass nodule size,burr sign,foliation sign,vascular cluster sign and pleural traction sign were P<.0.05 could be used as an independent risk factor for predicting malignant lung ground glass nodules.In contrast,patient age,type of lung ground glass nodules,vacuolar signs,and lymph node enlargement P>0.05 was not an independent risk factor for predicting malignant ground-glass nodules.Finally with the size as a predictor,nodules by ROC curve to forecast the malignant lung isolation,Ground glass nodules,analysis shows that:after AUC(area under the curve)is 0.869,the cutoff value:10.15,the sensitivity was 90.36%,87.94%,about an index of 0.783,show that cutoff value with the size of 10.15 mm nodules for grinding glass to malignant lung nodules(GGO,Ground Grass Opacity)have a very good prediction effect.Conclusion:Lung adenocarcinoma is the most common histopathological type of malignant lung ground glass nodules;(2)this study found that patients' age,grinding glass glass nodule size,pulmonary nodules of the lung type,burr,Ye Zheng,blood vessels,cluster sign,pleural pull),cavity),lymph node enlargement in good evil nature of pulmonary grinding glass statistical differences in the nodules,and pulmonary nodule size,grinding glass vessels cluster sign,pleural pull),and Ye Zheng glass mill can be used as a prediction of malignant lung nodules of the independent risk factors;(3)The diameter of pulmonary ground glass nodules was taken as the prediction index,and the truncation value of good prediction effect on malignant pulmonary ground glass nodules was 10.15mm,that is,when the diameter of pulmonary ground glass nodules was greater than 10.15mm,it suggested that the possibility of malignant nodules was higher.