| Objectives With the development of imaging technology and the improvement of people’s physical examination awareness,more and more ground-glass nodules have been found.There is a certain relationship between ground glass nodules and lung cancer,which may be the early manifestation of lung cancer.The objective of this study was to predict the independent risk factors of benign and malignant GGN by retrospective analysis of the clinical,hematological and imaging features of pathologically defined GGN inpatients,to establish a simple scale for predicting nodules,to help clinical doctors quickly the nature of the lung nodules grinding glass,make effective diagnosis and treatment plan.Methods 1 Research Subjects: In this study,150 patients with ground-glass nodules with definite pathological diagnosis who were admitted to the Affiliated Hospital of North China University of Science and Technology from September 2018 to September 2020 were selected.2 Research Methods: According to the pathological results,the subjects were divided into benign group and malignant group.Comparative analysis of the clinical features of two groups(gender,age,BMI,smoking history,drinking history,dust exposure history,family history of malignancy,history of COPD,clinical symptoms),hematology relate indicators(CEA,AFP,NSE,CA199,CA724,APTT,FIB,D-dimer,PLT,LDH),imaging characteristics(nodule size,position,type,boundary,spiculation sign,pleural indentation sign,vascular convergence sign,cavitation sign,vacuole sign,lobulation sign,bronchial inflatability sign,calcification).The above factors were analyzed by single factor analysis,t test was used for measurement data,chi-square test was used for counting data.The variables significance were analyzed by multiple logistic regression analysis.To further screen out the independent risk factors.The OR value of each factor was used as the scoring weight,and the independent risk factors were assigned to establish a nodule prediction scale.The 150 subjects were scored according to the nodule prediction scale.The diagnostic threshold of the prediction scale was screened by ROC curve.The authenticity of the prediction scale was evaluated by sensitivity and specificity,and the diagnostic consistency was evaluated by Kappa value.Results 1 In this study,univariate analysis showed that age,CEA,FIB,PLT,LDH,nodule size,spiculation sign,pleural indentation sign,vascular convergence sign,vacuole sign,lobulation sign,and bronchial inflatability sign were significantly different between benign group and malignant group.And gender,BMI,smoking history,drinking history,dust exposure history,family history of tumor,COPD history,cough,expectoration,blood in sputum,chest pain,dyspnea,AFP,NSE,CA199,CA724,APTT,D-dimer,nodal position,nodular type,nodular boundary,cavitation sign,calcification had no statistical significance between the two groups.2 Multiple Logistic regression analysis showed that age,CEA,PLT,spiculation sign,pleural indentation sign,vascular convergence sign,vacuole sign,lobulation sign were an independent influencing factors.According to Logistic regression coefficient OR value,independent factors were used to establish a prediction scale.Rating prediction scale based on 150 cases of the research object,and used ROC curve analysis.The results showed that the area under the curve was 0.95,the Yoden index was 0.81,the optimal threshold point was 12.5.Compared with pathological diagnosis,the prediction scale had a higher consistency,with a sensitivity of 95.7%,specificity of 85.3%,positive predictive value of 95.7% and negative predictive value of 85.3%.Conclusions 1 Age >50years,abnormal elevation of CEA and PLT,spiculation sign,pleural indentation sign,vascular convergence sign,vacuole sign and lobulation sign are independent risk factors for malignant ground glass pulmonary nodules.2 The 150 subjects were scored according to the constructed predictive scale.Through ROC curve analysis the optimal threshold point was 12.5.The total score was less than 12.5,which was recorded as benign;the total score was greater than or equal to 12.5,which was recorded as malignant.Compared with pathological diagnosis,the predictive scale has a higher consistency.Figure1;Table11;Reference 129... |
