| 易华,秦伟.CT影像学特征联合泛免疫炎症指数评估≤10mm孤立性肺结节老年患者恶性风险的价值[J].老年医学与保健,2025,31(6):1565-1570 |
| CT影像学特征联合泛免疫炎症指数评估≤10mm孤立性肺结节老年患者恶性风险的价值 |
| Value of CT imaging features combined with pan-immune inflammation index in evaluating malignant risk of solitary pulmonary nodules≤10 mm in elderly patients |
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| DOI：10.3969/j.issn.1008-8296.2025.06.029 |
| 中文关键词: 老年 CT 孤立性肺结节 炎症 恶性肺结节 |
| 英文关键词: elderly CT solitary pulmonary nodule inflammation malignant pulmonary nodule |
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| 中文摘要: |
| 目的 探究CT影像学特征联合泛免疫炎症指数(PIV)评估≤10 mm孤立性肺结节老年患者恶性风险的价值，旨在为老年肺结节患者恶性风险评估提供依据。方法 回顾性分析2022年5月—2025年6月收治于青岛市第八人民医院的210例孤立性肺结节≤10 mm的老年患者的临床资料，根据患者病理检查结果分为良性组(n=110)和恶性组(n=100)。观察并比较2组患者的一般临床资料、CT影像学特征及外周血炎症指标的差异。通过多因素Logistic回归分析方法筛选≤10 mm孤立性肺结节老年患者恶性风险的独立影响因素，通过受试者工作曲线(ROC)分析各因素独立及联合预测≤10 mm孤立性肺结节老年患者恶性风险的价值。结果 恶性组患者年龄、吸烟史比例、家族肿瘤史比例、结节大小、不规则形比例、混合磨玻璃/纯磨玻璃密度结节比例、毛刺征比例、空泡征比例、PIV、中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)水平均显著高于良性组，差异有统计学意义(P<0.05)。多因素Logistic回归分析发现，≤10 mm孤立性肺结节老年患者年龄较大、有吸烟史、结节较大、结节不规则形、混合磨玻璃/纯磨玻璃密度结节、存在毛刺征、合并空泡征、PIV水平较高均是恶性风险的独立危险因素(P<0.05)。ROC分析表明，≤10 mm孤立性肺结节老年患者年龄较大、有吸烟史、结节较大、结节不规则形、混合磨玻璃/纯磨玻璃密度结节、存在毛刺征、合并空泡征、PIV水平联合预测患者恶性风险的AUC较高[0.886(95%CI:0.843～0.930)]。结论 年龄、吸烟史、结节大小、形态、密度、毛刺征、空泡征、PIV均是孤立性肺结节老年患者恶性风险的独立影响因素。多种CT影像学特征联合PIV在预测孤立性肺结节老年患者恶性风险方面具有较高的价值。 |
| 英文摘要: |
| Objective To explore the value of CT imaging features combined with pan-immune-inflammation index(PIV)in evaluating the malignant risk of solitary pulmonary nodules(SPNs)≤10 mm in elderly patients,and provide evidence for malignant risk assessment in elderly patients with pulmonary nodules.Methods A retrospective analysis was conducted on the clinical data of 210 elderly patients with SPNs≤10 mm admitted to Eighth People's Hospital of Qingdao City from May 2022 to June 2025.According to the pathological examination results,the patients were divided into benign group and malignant group.The differences in general clinical data,CT imaging features,and peripheral blood inflammatory indicators were observed and compared between the two groups.Multivariate logistic regression analysis was used to screen the independent influencing factors for the malignant risk of SPNs≤10 mm in elderly patients.Receiver operating characteristic(ROC)curve analysis was used to evaluate the value of individual and combined factors in predicting malignant risk of SPNs≤10 mm in elderly patients.Results The age,proportion of smoking history,and proportion of family history of tumors in the malignant group were significantly higher than those in the benign group(P＜0.05).The nodule size,proportion of irregular shape,proportion of mixed ground-glass/pure ground-glass density nodules,proportion of spiculation sign,and proportion of vacuole sign in the malignant group were significantly higher than those in the benign group(P＜0.05).The levels of PIV,neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR)in the malignant group were significantly higher than those in the benign group(P＜0.05).Multivariate logistic regression analysis found that older age,smoking history,larger nodule size,irregular nodule shape,mixed ground-glass/pure ground-glass density nodules,presence of spiculation sign,presence of vacuole sign,and higher PIV level were all independent risk factors for malignant risk of SPNs≤10 mm in elderly patients(P＜0.05).ROC analysis showed that the combination of older age,smoking history,larger nodule size,irregular nodule shape,mixed ground-glass/pure ground-glass density nodules,presence of spiculation sign,presence of vacuole sign,and PIV level had a high AUC[0.886(95%CI:0.843～0.930)]for predicting malignant risk of SPNs≤10 mm in elderly patients.Conclusion Age,smoking history,nodule size,shape,density,spiculation sign,vacuole sign,and PIV are independent influencing factors for the malignant risk of SPNs in elderly patients.The combination of multiple CT imaging features and PIV has high value in predicting the malignant risk of SPNs in elderly patients. |
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