Clinical Analysis Of 183 Cases Of Pulmonary Cavitation

Objective: to discuss the clinical characteristics of pulmonary cavitation,analyze the relationship between its nature and clinical manifestations,laboratory examination indicators,CT signs and pathological results,and improve the clinical diagnosis ability of pulmonary cavitation.Methods:From October 2017 to October 2019,183 patients who showed pulmonary cavitation lesions under chest CT in yijishan hospital of wannan medical college and had a clear pathological diagnosis were collected.Collect patients' clinical data such as gender,age,smoking history,previous medical history(tumor history,hypertension,coronary heart disease,diabetes),clinical symptoms(cough,expectoration,hemoptysis,chest pain,chest tightness,fever,night sweats,fatigue,emaciation,hoarseness and enlarged lymph nodes),infection index(blood routine,CRP,ESR,PCT),tumor index(CEA,CA125,CYFRA21-1,SCC,Pro-GRP,NSE),chest CT data(whether the lesion is single,the specific location of the cavity lesion,its diameter,the shape of the cavity,whether it is thick-walled cavity,whether the inner wall is uniform,whether the cave wall contains calcification,burr signs,satellite lesions,pleural effusion,pleural depression,etc).According to the pathological results,183 patients were divided into malignant cavity group and benign cavity group,and the data collected above were analyzed statistically.By comparing the pathological results with the results of chest CT and tumor markers,the significance of different methods in the diagnosis of pulmonary cavitation lesions was analyzed to improve the clinical diagnosis ability of pulmonary cavitation lesions.Results: Among the 183 patients with pulmonary cavitation lesions,98 cases were in the malignant group and 85 cases were in the benign group,accounting for 53.55% and 46.45% respectively.Two groups of gender,age and smoking history between the two groups have difference(P<0.05).There was no difference in the history of hypertension,coronary heart disease and diabetes between the two groups.In laboratory examination,the difference in ESR in the benign and malignant group of cavity-induced lesions was only statistically significant(P<0.05),while the difference in other indicators in the two groups was not statistically significant.Among the lung tumor markers,the increased number of cases of cyfra21-1,CEA,CA125,NSE and SCC in patients with malignant lesions was higher than that in patients with benign cavity,and the difference between the two groups was statistically significant(P<0.05),while the difference in pro-grp between the two groups was not statistically significant.Of the 183 patients,there were 154 cases with single cavitation(84.15%)and 29 cases with multiple cavitation(15.85%).The difference has clinical value(P<0.05).In 154 cases of chest CT manifestation of solitary pulmonary cavity lesions,the position of the hole,size,eccentric hole,hole shape is irregular,calcification,the lining of tunnel wall uneven,contents,burr sign,blood vessels,cluster),satellite stove,enlarged lymph nodes between the two groups have difference(P< 0.05).Conclusion: For chest CT imaging findings of lesions in the right lower lung,eccentric cavitation,irregular shape of cavitation,uneven cavitation inner margin,burr sign,vascular cluster sign,lymph node enlargement cavitation patients should pay attention to the possibility of screening for malignant tumor.The comprehensive analysis of tumor markers,imaging and pathological results of patients can improve the accuracy of the diagnosis of pulmonary cavitation lesions and contribute to the early diagnosis of the disease.