恶性肺上叶后段占位性病变CT良性影像表现的相关研究

摘要

目的 探究恶性肺上叶后段占位性病变电子计算机断层扫描(computed tomography,CT)良性表现的危险因素,为临床诊断提供理论依据.方法 回顾性研究首都医科大学宣武医院及首都医科大学附属北京友谊医院平谷医院胸外科2011年1月1日至2016年12月31日肺上叶后段占位性病变CT良性表现病人139例.计算各年份恶性肺上叶后段占位性病变CT良性影像表现的发生率;对比病人的各项临床资料,并采用Logistic回归分析危险因素.结果 各年恶性肺上叶后段占位性病变CT良性影像表现的发生率分别为8.33%、11.11%、19.05%、26.92%、34.38%、40.00%;Logistic回归显示:年龄、吸烟、右位病变、单光子弥散计算机断层成像术(single-photon emission computed tomography,SPECT)放射凝聚征阳性、癌胚抗原(carcino-embryonic antigen,CEA)、细胞角蛋白19片段21-1(cytokeratin protein fragment 21-1,CYFRA21-1)及神经元特异性烯醇化酶(neuron specific enolase,NSE)异常,为恶性肺上叶后段占位性病变CT良性表现的危险因素,OR(95%CI)分别是1.123(1.038~1.215)、5.951(1.778~9.919)、3.547(1.104~10.397)、3.565(1.096~11.598)、18.638(4.974~29.843)、7.357(2.265~13.010)、7.639(3.107~14.697).结论 恶性肺上叶后段占位性病变CT良性影像表现的发生率较高,值得重视;危险因素为老龄、吸烟、右位病变、SPECT放射凝聚征阳性及肺癌相关肿瘤标志物异常,临床医师需谨慎对待,早发现、早治疗,以提高病人生存率.%Objective To investigate risk factors of the malignant space-occupying disease with benign computed tomography (CT) graph on upper lobe-back segment of lung, so as to provide theoretic basis for clinical diagnosis.Methods Retrospective study of the 139 patients with the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung,from Department of Thoracic Surgery, Xuanwu hospital, Capital Medical University and Department of Thoracic Surgery, Pinggu Hospital, Friendship Hospital, Capital Medical University, from January 1, 2011 to December 31st, 2016.The incidence rates of each year were calculated.We compared the clinical data of patients and used Logistic regression to analyze the risk factors in our study.Results Incidence rates of the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung in each year were 8.33%, 11.11%, 19.05%, 26.92%, 34.38%, 40.00% respectively.Logistic regression showed the risk factors OR (95%CI) of the malignant space-occupying disease with benign CT graphy on upper lobe-back segment of lung were: ages 1.123(1.038-1.215), smoking 5.951(1.778-9.919), right space-occupying diseases 3.547(1.104-10.397), positive single-photon emission computed tomography (SPECT)agglomeration 3.565(1.096-11.598), abnormal related marks of lung cancer [carcino-embryonic antigen (CEA), cytokeratin protein fragment 21-1 (CYFRA21-1), neuron specific enolase (NSE)] 18.638 (4.974-29.843), 7.357(2.265-13.010), 7.639(3.107-14.697). Conclusion The incidence rates of the malignant space-occupying disease with benign CT graph on upper lobe-back segment of lung in each year were high, and doctors should pay more attentions to considerate risk factors such as ages, smoking, right space-occupying diseases, positive SPECT agglomeration as well as abnormal related marks of lung cancer when they diagnose. Early detection and early treatment can improve the survival of patients.