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目的探讨孤立性肺结节(SPN)患者临床特征与SPN病理间的关系。方法回顾性调查2009年1月1日至2013年12月31日在南京军区福州总医院、厦门大学附属福州市第二医院病理确诊SPN的患者231例。以病理结果为参考标准,分别比较不同病理类型SPN患者的性别、年龄、吸烟史、吸烟量、戒烟史、肺外恶性肿瘤病史的差异。结果女性、年龄与SPN恶性概率呈正相关,回归系数分别为1.090、0.063。肺外恶性肿瘤病史、吸烟史、吸烟量、戒烟史与SPN恶性概率无相关性。SPN的病理类型存在性别差异,其中癌前病变、肺曲霉病、肺硬化性血管瘤、腺癌为女性多于男性,肺结核、肺隐球菌病、鳞癌、腺鳞癌、炎性假瘤和转移癌均为男性多于女性。SPN病理类型在各个年龄段间疾病分布一致。癌前病变、肺错构瘤、肺曲霉病、肺硬化性血管瘤、腺癌、炎性假瘤的患者多数不吸烟。结论性别、年龄有助于鉴别诊断SPN良恶性,结节病理类型与性别、吸烟相关。
Objective To investigate the relationship between the clinical features of SPN and the pathology of solitary pulmonary nodules (SPN). Methods A retrospective survey of 231 patients with pathologically diagnosed SPN in Fuzhou General Hospital of Nanjing Military Command and Fuzhou Second Affiliated Hospital of Xiamen University from January 1, 2009 to December 31, 2013 was retrospectively reviewed. Pathological results as a reference standard, respectively, compared with different pathological types of SPN patients gender, age, smoking history, smoking, smoking cessation history, history of extrapulmonary malignant disease. Results Female, age and SPN malignant probability was positively correlated, the regression coefficients were 1.090,0.063. There was no correlation between the history of extrapulmonary malignant tumors, the history of smoking, the amount of smoking, the history of smoking cessation and the malignancy of SPN. SPN pathological types of gender differences, including precancerous lesions, pulmonary aspergillosis, pulmonary sclerosing hemangioma, adenocarcinoma of women than men, tuberculosis, pulmonary cryptococcosis, squamous cell carcinoma, adenosquamous carcinoma, inflammatory pseudotumor and Metastatic cancer are more men than women. The SPN pathology is consistent across all age groups. Pre-cancerous lesions, lung hamartoma, pulmonary aspergillosis, pulmonary sclerosing hemangioma, adenocarcinoma, inflammatory pseudotumor most patients do not smoke. Conclusion The gender and age are helpful to differentiate benign and malignant SPN. The pathological type of nodules is related to sex and smoking.