目的比较X线胸片、CT在肺癌与良性肿瘤鉴别中的应用效果。方法随机选取2016年6月～2018年6月我院收治的肺癌与良性肿瘤患者60例,依据放射诊断方法将这些患者分为两组,即X线胸片诊断组(X线组)和CT诊断组(CT组),每组30例,统计分析两组患...目的比较X线胸片、CT在肺癌与良性肿瘤鉴别中的应用效果。方法随机选取2016年6月～2018年6月我院收治的肺癌与良性肿瘤患者60例,依据放射诊断方法将这些患者分为两组,即X线胸片诊断组(X线组)和CT诊断组(CT组),每组30例,统计分析两组患者的影像学表现、鉴别诊断肺癌与肺部良性肿瘤的敏感度、特异度。结果 CT组患者中有毛刺或锯齿状、肺叶一侧或全肺不张比例43.3%(13/30)、16.7%(5/30)均显著高于X线组36.7%(11/30)、10.0%(3/30)(P<0.05),但两组患者中缺乏规则的边缘或分叶征、病灶呈孤立性结节状周围型比例20.0%(6/30)、16.7%(5/30) vs 23.3%(7/30)、20.0%(6/30)之间的差异均不显著(P>0.05)。CT组鉴别诊断肺癌与肺部良性肿瘤的敏感度、特异度92.1%、89.0%、93.6%、95.0%均显著高于X线组83.3%、80.5%、84.2%、82.3%(P<0.05)。结论 CT在肺癌与良性肿瘤鉴别中的应用效果较X线胸片好,影像学表现较为突出,敏感度、特异度均较高,值得在临床推广应用。展开更多
Background： Serum cryptococcal antigen （CrAg） test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this...Background： Serum cryptococcal antigen （CrAg） test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus （HIV） adult patients with pulmonary cryptococcosis and its clinical features. Methods： One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive （CrAg＋ group） and 29 were negative （CrAg- group）. It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio （OR） was used to measure correlation. Student＇s t-test was obtained to analyze continuous variable. Results： No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups （P 〉 0.05 in all）. Nevertheless, diffuse extent lesion was 82.1% in CrAg＋ group and 10.3% in CrAg- group （χ2 = 40.34, P〈 0.001; OR = 39.87）. Conclusions： Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.展开更多
文摘目的比较X线胸片、CT在肺癌与良性肿瘤鉴别中的应用效果。方法随机选取2016年6月～2018年6月我院收治的肺癌与良性肿瘤患者60例,依据放射诊断方法将这些患者分为两组,即X线胸片诊断组(X线组)和CT诊断组(CT组),每组30例,统计分析两组患者的影像学表现、鉴别诊断肺癌与肺部良性肿瘤的敏感度、特异度。结果 CT组患者中有毛刺或锯齿状、肺叶一侧或全肺不张比例43.3%(13/30)、16.7%(5/30)均显著高于X线组36.7%(11/30)、10.0%(3/30)(P<0.05),但两组患者中缺乏规则的边缘或分叶征、病灶呈孤立性结节状周围型比例20.0%(6/30)、16.7%(5/30) vs 23.3%(7/30)、20.0%(6/30)之间的差异均不显著(P>0.05)。CT组鉴别诊断肺癌与肺部良性肿瘤的敏感度、特异度92.1%、89.0%、93.6%、95.0%均显著高于X线组83.3%、80.5%、84.2%、82.3%(P<0.05)。结论 CT在肺癌与良性肿瘤鉴别中的应用效果较X线胸片好,影像学表现较为突出,敏感度、特异度均较高,值得在临床推广应用。
基金This work was supported by the grants from Guangzhou Programs for Natural Science Foundation of Guangdong Province （No. 201707010282）, Scientific Research Project of Guangzhou （No. 2017A030310286）, the National Natural Science Foundation of China （No. 81670071 ）, and Science and Technology Planning Project of Guangdong Province （No. 2014A020212627）.
文摘Background： Serum cryptococcal antigen （CrAg） test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus （HIV） adult patients with pulmonary cryptococcosis and its clinical features. Methods： One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive （CrAg＋ group） and 29 were negative （CrAg- group）. It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio （OR） was used to measure correlation. Student＇s t-test was obtained to analyze continuous variable. Results： No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups （P 〉 0.05 in all）. Nevertheless, diffuse extent lesion was 82.1% in CrAg＋ group and 10.3% in CrAg- group （χ2 = 40.34, P〈 0.001; OR = 39.87）. Conclusions： Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.
