| 【Objective】Using AI and physician read HRCT images,combined with traditional Chinese medicine constitution classification and pathological classification,summarizes the grinding glass constitution type characteristics of patients with pulmonary nodules and ground glass pulmonary nodules benign and malignant relations with relevant factors such as physical type,for the early diagnosis of malignant lung nodules and pulmonary malignant tumor early health intervention to provide certain reference basis.【 Methods 】 Selected 210 patients with single ground-glass pulmonary nodules admitted by the three project hospitals between January 2020 and August 2020.All patients received chest high-resolution CT examination and histomathological examination.The high-resolution CT images were read by artificial and AI,and the constitution types of TCM were determined.The constitution types of patients with ground-glass pulmonary nodules were statistically classified,and analyze the date obtained with SPSS22.0.【Results】1.Among 210 cases of GGN,86 cases were male(40.95%)and 124 cases were female(59.05%).There were 159 cases of malignant nodules(75.71%)and 51 cases of benign nodules(24.29%).2.AI diagnosed 165 cases of malignant GGN and 45 cases of benign GGN.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 96.86%,78.43%,92.38%,93.33%,and 88.89%,respectively,for the detection of malignant ground glass pulmonary nodules.3.Doctors diagnosed 154 cases of malignant GGN and 56 cases of benign GGN.Mc Nemar test showed that there was no statistical difference in the sensitivity of AI and manual image reading to identify ground-glass pulmonary nodules(P=0.375),and the rate of missed diagnosis was similar between the two.The diagnostic specificity of AI was lower than that of artificial diagnosis(P=0.039),and the misdiagnosis rate of AI was higher than that of artificial diagnosis.4.Among 210 GGN cases,47 cases(22.38%)had moderate constitution and 163cases(77.62%)had biased constitution.The main components of the 163 patients were as follows: qi-stagnation 49 cases(30.06%),qi-deficiency 35 cases(21.47%),yang-deficiency 24 cases(14.72%),phlegm-dampness 17 cases(10.43%),yin-deficiency 14 cases(8.59%),blood-stasis 11 cases(6.75%),dampness-heat 9cases(5.52%),and intrinsic 4 cases(2.45%).5.Of the 159 patients with malignant ground glass pulmonary nodules,11 cases(6.92%)had mild constitution,26 cases(16.35%)had single bias constitution,and122 cases(76.73%)had double bias constitution.According to the occurrence frequency,all the constitutive types of patients with malignant ground glass pulmonary nodule were counted as follows: 78 cases of qi deficiency,66 cases of qi stagnation,61 cases of Yang deficiency,50 cases of Yin deficiency,45 cases of blood stasis,36 cases of phlegm dampness,30 cases of dampness and heat,11 cases of calm quality,and 9 cases of special quality.Among the 51 benign ground glass pulmonary nodules,36 cases(70.59%)were mild,12 cases(23.53%)were single biased and 3cases(5.88%)were mixed biased.Compared with benign nodules,malignant ground glass pulmonary nodules with pinch-bias constitution were more common and mild constitution was less(P < 0.01).6.The proportion of female in malignant GGN was higher than that in benign GGN,the mean CT value,longest diameter,volume and predicted malignant probability of nodules were all higher than that in benign GGN,and the number of burr/lobular and mixed ground glass nodules was higher than that in benign GGN(all P < 0.05).There were no significant correlation with age,shortest diameter of nodules and relationship between nodules and bronchus(P > 0.05).7.The results of multivariate Logistic regression analysis showed that female,large mean CT value of nodules,large volume of nodules,burr and lobulation of nodules,mixed ground glass nodules and bias constitution were independent risk factors for malignant GGN,with OR values of 3.154,1.142,1.307,2.313,4.238,3.949,respectively.【Conclusions】1.The sensitivity,specificity and accuracy of AI were 96.86%,78.43% and 92.38%for malignant GGN.2.The misdiagnosis rate of AI was similar to that of doctors’ misdiagnosis rate of malignant ground glass pulmonary nodules,and the misdiagnosis rate of AI was higher than that of manual diagnosis.3.The patients with ground glass pulmonary nodules were mainly biased constitutio,and qi-stagnation was the most common type of main substance.4.Malignant ground glass pulmonary nodules are mainly composed of double bias constitution,single bias constitution is rare,and qi-deficiency is the most frequent.5.Compared with benign nodules,malignant ground glass pulmonary nodules with clamping bias were more common and mild constitution was less.6.Female,large mean CT value of nodules,large volume of nodules,burr and lobulation at the edge of nodules,mixed ground glass nodules and biased constitution were independent risk factors for malignant GGN,with OR values of 3.154,1.142,1.307,2.313,4.238,3.949,respectively. |
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