摘要
目的分析中老年患者早期肺腺癌胸部影像是磨玻璃结节(GGN)的临床特点。方法回顾性分析性闵行区中心医院2018年1月-2020年12月经社区转诊收治的胸部CT显示有磨玻璃结节的116例中老年患者的临床资料,依据胸腔镜术后病理分为浸润前病变组(n=24)和浸润性病变组(n=92),观察并比较2组血清肿瘤标记物CA211水平和GGN直径,分析血清CA211和GGN直径在中老年人浸润性肺磨玻璃结节的诊断中的价值。结果血清肿瘤标记物CA211水平在2组之间的差异有统计学意义(P<0.05),其辅助诊断的灵敏度为72.8%、特异度为79.2%,截断值为2.325 U/mL。GGN直径在2组之间的差异有统计学意义(P<0.05),其诊断浸润性病变的灵敏度为70.7%、特异度为79.2%,截断值为9.5 mm。浸润性病变危险因素分析发现,GGN的类型、毛刺征、分叶征、CA211水平为肺腺癌的独立危险因素(P<0.05)。风险预测模型logit(P)=-4.565+4.157×GGN类型+3.530×毛刺征+2.115×分叶征+0.982×CA211。结论血清CA211水平>2.325 U/mL、GGN直径>9.5 mm对中老年患者浸润性肺磨玻璃结节的诊断有一定的价值;中老年患者影像学出现毛刺征、分叶征、CA211水平升高的磨玻璃结节,提示浸润性病变的风险更高。
Objective To analyze the clinical characteristics of ground glass nodules(GGN)in chest images of middle-aged and elderly patients with early lung adenocarcinoma.Methods The clinical data of 116 middle-aged and elderly patients with GGN on chest CT images referred from community to Central Hospital of Minhang District from January 2018 to December 2020 were analyzed retrospectively.According to the pathology after thoracoscopy,they were divided into pre-invasive lesion group(n=24)and invasive lesion group(n=92).The levels of serum tumor marker CA211 and GGN diameter of the two groups were observed and compared.The values of serum CA211 and GGN diameter in the diagnosis of invasive pulmonary GGN in the middle-aged and elderly were analyzed.Results There was statistical difference in the level of serum CA211 between the two groups(P<0.05),and the sensitivity,specificity and cut-off value of serum CA211 in the diagnosis of invasive lesion were 72.8%,79.2%and 2.325 U/mL,respectively.There was statistical difference in GGN diameter between the two groups(P<0.05),and the sensitivity,specificity and cut-off value of GGN in the diagnosis of invasive lesion were 70.7%,79.2%and 9.5 mm,respectively.Risk factors analysis of invasive lesions showed that the type of GGN,burr sign,lobular sign,and CA211 level were independent risk factors for lung adenocarcinoma(P<0.05).The risk prediction model logit(P)=4.565+4.157×GGN type+3.530×burr sign+2.115×lobular sign+0.982×CA211.Conclusion The level of serum CA211>2.325 U/mL and GGN diameter>9.5 mm have certain value in the diagnosis of invasive pulmonary GGN in middle-aged and elderly patients.The imaging manifestations of GGN with burr sign and lobular sign and elevated serum CA211 level suggest a higher risk of invasive lesion in middle-aged and elderly people.
作者
齐郑
颜志军
杨玲
Qi Zheng;Yan ZhiJun;Yang Ling(Department of Geriatrics,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai,200092,P.R.China;Health Service Center of Huacao Community,Minhang District,Shanghai,201107,P.R.China;Central Hospital of Minhang District,Shanghai,201100,P.R.China)
出处
《老年医学与保健》
CAS
2021年第5期1019-1023,共5页
Geriatrics & Health Care
基金
上海市科学技术委员会基金(18441905200)
.上海市转化医学协同创新中心研究项目(TM202008)
上海交通大学中国医院发展研究院医院发展战略研究所项目(HDSI-2020-B-010)
上海交通大学2020年度“技术推广项目”(ZT202003)。
关键词
肺腺癌
磨玻璃结节
肺癌筛查
lung adenocarcinoma
ground glass nodules
lung cancer screening
