The Relationship between Clinical Characteristics and Pathology Findings of Solitary Pulmonary Nodules_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 SheHui ¹ , FangZhenjian ¹ , ChengFangrong ¹ , DongFang ¹ , LaiGuoxiang ²

1. Department of Respiratory Medicine, Affiliated Fuzhou Second Hospital of Xiamen University, Fuzhou, Fujian, 350007, China;
2. ;

Corresponding?author：

SheHui, Email: shui_317@163.com

Keywords：

Solitary pulmonary nodule; Differential diagnosis; Neoplams; Gender; Age; Smoking

DOI：

10.7507/1671-6205.2015093

Video：

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Objective To elucidate the relationship between clinical characteristics and pathology findings of solitary pulmonary nodules (SPN). Methods A retrospective cohort study was carried out on 231 SPN patients pathologically confirmed between January 2009 and December 2013 in Nanjing General Hospital of Fuzhou Military Command and Fuzhou Second Hospital. Using pathological results as reference standard, the sex, age, smoking history, smoking amount, quit smoking history, and extrapulmonary malignant tumor history were compared between the SPN patients with different pathological type. Results Female and age were positively correlated with the probability of malignancy in SPN with correlation coefficients as 1.090 and 0.063 respectively. Extrapulmonary malignant tumor history, smoking history, smoking amount, quit smoking history did not show significant relationship. Gender was a factor that affects pathological types of SPN. Female patients were in higher risk than male patients to have precancerous lesions, pulmonary aspergillosis, pulmonary sclerosing hemangioma, adenocarcinoma. Male patients had higher risk suffering from pulmonary tuberculosis, pulmonary cryptococcosis, squamous cell carcinoma, adenosquamous carcinoma, inflammatory pseudotumor and metastases. Distribution of SPN pathologic types in each age group was similar. Most patients who had precancerous lesions, pulmonary hamartoma, pulmonary aspergillosis, pulmonary sclerosing hemangioma, adenocarcinoma and inflammatory pseudotumor were not smokers. Conclusions Gender and age are valuable in distinguishing benign SPN from malignant SPN. Pathologic types of SPN are related to patients' gender and smoking history.

Citation： SheHui, FangZhenjian, ChengFangrong, DongFang, LaiGuoxiang. The Relationship between Clinical Characteristics and Pathology Findings of Solitary Pulmonary Nodules. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(4): 376-379. doi: 10.7507/1671-6205.2015093 Copy

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2.	歐兆榮, 陶連琴, 時國朝, 等.孤立性肺結節的影像學特征及兩種肺癌預測模型的比較.中國呼吸與危重監護雜志, 2012, 11:168-171.
3.	Gould MK, Fletcher J, Iannettoni MD, et al.Evaluation of patients with pulmonary nodules:when is it lung cancer? ACCP evidence-based clinical practice guidelines(2nd edition).Chest, 2007, 132(3 Suppl):108S-130S.
4.	Henschke CI, Mccauley DI, Yankelevitz DF, et al.Early Lung Cancer Action Project:overall design and findings from baseline screening.Lancet, 1999, 354:99-105.
5.	Goldstraw P, Crowley J, Chansky K, et al.The IASLC Lung Cancer Staging Project:proposals for the revision of the TNM stage groupings in the forthcoming(seventh) edition of the TNM Classification of malignant tumours.J Thorac Oncol, 2007, 2:706-714.
6.	Henschke CI, Yankelevitz DF, Libby DM, et al.Survival of patients with stageⅠlung cancer detected on CT screening.N Engl J Med, 2006, 355:1763-1771.
7.	中國抗癌協會肺癌專業委員會, 吳一龍, 蔣國樑, 等.孤立性肺結節的處理.循證醫學, 2009, 9:243-246.
8.	Swensen SJ, Silverstein MD, Ilstrup DM, et al.The probability of malignancy in solitary pulmonary nodules.Application to small radiologically indeterminate nodules.Arch Intern Med, 1997, 157:849-855.
9.	Jemal A, Bray F, Center MM, et al.Global cancer statistics.CA Cancer J Clin, 2011, 61:69-90.
10.	邢昕, 廖永德, 唐和孝, 等.肺癌的性別差異及機制.中國肺癌雜志, 2011, 14:625-630.
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12.	Herder GJ, Van Tinteren H, Golding RP, et al.Clinical prediction model to characterize pulmonary nodules:validation and added value of 18F-fluorodeoxyglucose positron emission tomography.Chest, 2005, 128:2490-2496.
13.	Chen KY, Chang CH, Yu CJ, et al.Distribution according to histologic type and outcome by gender and age group in Taiwanese patients with lung carcinoma.Cancer, 2005, 103:2566-2574.
14.	袁濤, 于鐵鏈.非典型肺轉移瘤的放射學表現.國外醫學(臨床放射學分冊), 2003, 26:190-191.
15.	Pirozynski M.100 years of lung cancer.Respir Med, 2006, 100:2073-2084.
16.	王冬梅, 李為民, 李靜, 等.吸煙與肺癌關系的Meta分析.中國呼吸與危重監護雜志, 2009, 8:229-233.
17.	李志忠, 王樂強, 莊洪潔.吸煙與肺癌類型關系的探討.中華流行病學雜志, 2002, 13:369.
18.	趙寧, 俞順章.我國吸煙與肺癌關系的Meta-analysis:15個病例對照研究的合并分析.中華流行病學雜志, 1993, 14:350-354.

1. Ost D, Fein AM, Feinsilver SH.Clinical practice.The solitary pulmonary nodule.N Engl J Med, 2003, 348:2535-2542.
2. 歐兆榮, 陶連琴, 時國朝, 等.孤立性肺結節的影像學特征及兩種肺癌預測模型的比較.中國呼吸與危重監護雜志, 2012, 11:168-171.
3. Gould MK, Fletcher J, Iannettoni MD, et al.Evaluation of patients with pulmonary nodules:when is it lung cancer? ACCP evidence-based clinical practice guidelines(2nd edition).Chest, 2007, 132(3 Suppl):108S-130S.
4. Henschke CI, Mccauley DI, Yankelevitz DF, et al.Early Lung Cancer Action Project:overall design and findings from baseline screening.Lancet, 1999, 354:99-105.
5. Goldstraw P, Crowley J, Chansky K, et al.The IASLC Lung Cancer Staging Project:proposals for the revision of the TNM stage groupings in the forthcoming(seventh) edition of the TNM Classification of malignant tumours.J Thorac Oncol, 2007, 2:706-714.
6. Henschke CI, Yankelevitz DF, Libby DM, et al.Survival of patients with stageⅠlung cancer detected on CT screening.N Engl J Med, 2006, 355:1763-1771.
7. 中國抗癌協會肺癌專業委員會, 吳一龍, 蔣國樑, 等.孤立性肺結節的處理.循證醫學, 2009, 9:243-246.
8. Swensen SJ, Silverstein MD, Ilstrup DM, et al.The probability of malignancy in solitary pulmonary nodules.Application to small radiologically indeterminate nodules.Arch Intern Med, 1997, 157:849-855.
9. Jemal A, Bray F, Center MM, et al.Global cancer statistics.CA Cancer J Clin, 2011, 61:69-90.
10. 邢昕, 廖永德, 唐和孝, 等.肺癌的性別差異及機制.中國肺癌雜志, 2011, 14:625-630.
11. 陳灝珠, 林果為, 戴自英, 等.實用內科學.第13版.北京:人民衛生出版社, 2009, 1798-1809.
12. Herder GJ, Van Tinteren H, Golding RP, et al.Clinical prediction model to characterize pulmonary nodules:validation and added value of 18F-fluorodeoxyglucose positron emission tomography.Chest, 2005, 128:2490-2496.
13. Chen KY, Chang CH, Yu CJ, et al.Distribution according to histologic type and outcome by gender and age group in Taiwanese patients with lung carcinoma.Cancer, 2005, 103:2566-2574.
14. 袁濤, 于鐵鏈.非典型肺轉移瘤的放射學表現.國外醫學(臨床放射學分冊), 2003, 26:190-191.
15. Pirozynski M.100 years of lung cancer.Respir Med, 2006, 100:2073-2084.
16. 王冬梅, 李為民, 李靜, 等.吸煙與肺癌關系的Meta分析.中國呼吸與危重監護雜志, 2009, 8:229-233.
17. 李志忠, 王樂強, 莊洪潔.吸煙與肺癌類型關系的探討.中華流行病學雜志, 2002, 13:369.
18. 趙寧, 俞順章.我國吸煙與肺癌關系的Meta-analysis:15個病例對照研究的合并分析.中華流行病學雜志, 1993, 14:350-354.

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The Relationship between Clinical Characteristics and Pathology Findings of Solitary Pulmonary Nodules

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