Analysis Of Postoperative Pathological And Clinical Features Of Pulmonary Nodules

Objective:Through the collection of clinical data of postoperative pathological diagnosis of patients with suspected malignant pulmonary nodules in our hospital,the percentage of malignant pulmonary nodules,the correlation between clinical features,chest CT images,serological indexes and pathological diagnosis were statistically analyzed.Methods:Collect on January 1,2019 to December 31,2019 in our hospital surgical resection of 911 patients with suspected pulmonary nodules of lung cancer with clinical data,clinical characteristics,such as age,gender,smoking history and symptoms,chest CT imaging features,such as nodule diameter,location,density,malignant signs and changes in nodules,serological indecators such as tumor markers,erythrocyte sedimentation rate and D-dimer,and postoperative pathological diagnosis of the patients were recorded.The percentage of malignant nodules and their collection with the above characteristics were analyzed retrospectively.Results:1.There were 803 cases of malignant nodules in this group,accounting for 88.14%of the total number.The female was significantly more than the male,and the male to female ratio was 1:2.06.The comparison between the benign and malignant nodules group was P<0.05,the difference was statistically significant.Male and female malignant nodules,lung cancer in the age group of 60-69 years accounted for the highest proportion.Microinvasive adenocarcinoma was more common in patients aged 20-29 years and 30-39 years,after the age of 40-49 years,invasive adenocarcinoma was more common,and the number of invasive adenocarcinoma increased significantly at the age of 60-69 years and 70-79 years,and all the 5 patients aged ≥80 years had invasive adenocarcinoma.It can be seen that the degree of invasive lung adenocarcinoma increased with the increase of age.2.In this group,smokers only accounted for 17.34%of the total,and there was no significant difference in smoking history between benign and malignant groups.Adenocarcinoma was more common in women and non-smokers at all ages,while squamous cell carcinoma was more common in men and smokers.3.In this study,postoperative pathology of 911 patients with pulmonary nodules was malignant in 803 cases(88.14%),most of which were lung cancer(787 cases),among which lung adenocarcinoma(764 cases)was the most common,accounting for 95.15%of malignant nodules,followed by squamous cell carcinoma(16 cases,1.99%).The proportion of atypical adenomatoid hyperplasia,in situ adenocarcinoma,micro-invasive adenocarcinoma,invasive adenocarcinoma and adenocarcinoma variant(mucinous adenocarcinoma)in lung adenocarcinoma was 0.92%,13.48%,32.07%,50.65%and 2.49%,respectively,and the proportion of invasive adenocarcinoma was the highest.4.In this study,477 cases(59.40%)were found in asymptomatic physical examination,significantly more than 326 cases(40.60%)with symptoms,and cough and expectoration were the most common.5.In this study,the nodules were grouped according to their diameter ≤5mm,6-10mm,11-20mm and 21-30mm,the proportion of malignant nodules in the 6-10mm,11-20mm and 21-30mm groups was significantly higher than that in the ≤5mm group.Compared with ≤5mm group,6-10mm group,11-20mm group and 21-30mm group,P<0.05,the difference was statistically significant.However,there was no significant difference among the groups of 6-10mm,11-20mm and 21-30mm(P>0.05).The infiltration degree of lung adenocarcinoma gradually increased with the increase of the diameter of pulmonary nodules.6.Nodule density and malignant signs were significantly different between benign and malignant groups(P<0.05),but nodule location and short-term changes were not significantly different between benign and malignant groups(P>0.05).Compared to the left lung and lower lobe,lung cancer is more located in the right lung and upper lobe.7.CEA,Cyfra21-1,NSE,SCC and Pro-GRP showed no significant differences between benign and malignant nodules(P>0.05),but the positive rate of CEA increased with the increase of nodules diameter.Conclusion:This study showed that malignant nodules accounted for 88.14%,mainly female patients aged 60-69 who did not smoke,and most of them were found in asymptomatic physical examination.The most common malignant nodules were lung adenocarcinoma,and with the increase of age and diameter of nodules,the infiltration degree of lung adenocarcinoma gradually increased.The density and malignant signs of pulmonary nodules under CT have diagnostic value for malignant nodules.