Study On Malignant Risk Factors Of Sub-centimeter Solid Lung Nodules

Objective:With the popularization of low-dose spiral CT in the early screening of lung cancer,more and more people have detected lung nodules.Sub-centimeter solid lung nodules(?1cm in diameter)are one type of lung nodules.It is a difficult problem to accurately determine the benign and malignant sub-centimeter solid lung nodules.This study aims to find out the malignant risk factors of sub-centimeter solid lung nodules through clinical and imaging data of patients with sub-centimeter solid lung nodules,and provide help for clinicians' diagnosis and treatment.Methods:Collected clinical and imaging data of 202 patients with sub-centimeter solid lung nodules who underwent surgical treatment in the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital)from June 2018 to December 2019:gender,age,smoking history,Family tumor history,preoperative carcinoembryonic antigen examination value,pathological diagnosis results,maximum nodule diameter,nodule location(upper and non-upper lobe),whether the edge is smooth,the lobularity sign,the spiculation sign,the pleural retraction sign,the vacuole sign,the vascular convergence sign,the air bronchogram sign,and calcification.The patients were divided into two groups,benign and malignant.The SPSS 23.0 software was used to perform a single factor analysis on the above clinical and imaging data to find out the influential factors with statistical significance,and then included in the multivariate logistic regression analysis to select malignant independent risk factors.Results:Among 202 patients with sub-centimeter solid pulmonary nodules,93 were male and 109 were female,with an average age of 52.67±10.50 years.The average diameter of nodules was 8.37 mm±1.52 mm,the average diameter of benign nodules was 7.83 mm±1.59 mm,and the average diameter of malignant nodules was 8.70 mm±1.39 mm.76 patients with benign sub-centimeter solid pulmonary nodules,of which a total of 30 cases had chronic organizing inflammation,the rest were 21 cases of tuberculosis,11 cases of hamartoma,8 cases of inflammatory granuloma,and sclerosing hemangioma 5 One case of chronic lymphadenitis.There were 126 patients with malignant sub-centimeter solid pulmonary nodules,of which there were a total of 115 cases with adenocarcinoma,the rest were 8 cases of squamous cell carcinoma,1 case of adenosquamous cell carcinoma,and 2 cases of small cell carcinoma.There are 115 cases of sub-centimeter solid lung adenocarcinoma.Among the subtype distribution,there are a maximum of 33 cases with acinar-like predominant type,the rest are 28 cases with papillary-like predominant type,17 cases with wall-like predominant type,microscopic There were 11 cases of infiltrating adenocarcinoma,5 cases of variant adenocarcinoma,6 cases of solid predominant type,2 cases of micropapillary predominant type,13 cases of atypical neoplasia and adenocarcinoma in situ.Univariate analysis screened out benign and malignant patients with statistically significant differences in age.nodule maximum diameter,upper lobe,unsmooth edge,lobulation sign,spiculation sign,vacuole sign,air bronchial sign and vascular convergence sign.After multivariate logistic regression analysis,age,upper lobe,unsmooth edge,lobulation sign,vacuole sign and vascular convergence sign were selected as malignant independent risk factors for sub-centimeter solid lung nodules.Conclusion:With the popularity of early screening for lung cancer,more and more patients with pulmonary nodules are found.It is difficult to judge the pathological properties of solid lung nodules in sub-centimeter of lung nodules.In this study,202 patients with sub-centimeter solid lung nodules were statistically analyzed based on the clinical and imaging characteristics of the patients,and the following conclusions were drawn:1.With the increase of age,the malignant proportion of sub-centimeter solid lung nodules also increases.Older age is a malignant independent risk factor for patients with sub-centimeter solid lung nodules.2.CT imaging characteristics are the main basis for judging the nature of sub-centimeter lung nodules.This study found that the nodules are located in the upper lobe,the edges are not smooth,the lobulated sign,the vacuole sign and the vascular registration sign are sub-centimeter solid lung nodules.The malignant independent risk factors need to be paid attention to in clinical work.