结核与肺部疾病杂志2025，Vol.6Issue(5)：516-524,9.DOI:10.19983/j.issn.2096-8493.20250065
血清炎症指标联合胸部CT对良恶性肺结节的鉴别诊断价值
The value of serum inflammatory index combined with chest CT in differential diagnosis of benign and malignant pulmonary nodules
摘要
Abstract
Objective:To analyze the value of serum inflammatory indexes combined with chest CT on differential diagnosis of benign and malignant pulmonary nodules.Methods:Two hundred and fifty-three patients with lung nodules who visited the Third People's Hospital of Kunming from August 2022 to August 2024 were enrolled as study subjects,all of whom were diagnosed by CT-guided percutaneous lung puncture technique after admission to the hospital,with clear pathological examination results.Among them,127 patients with lung cancer were deemed as the malignant lung nodule group,and 126 patients with benign lung nodules were deemed as the benign lung nodule group.The patients' medical history,imaging data,serum inflammatory markers and other data were collected to explore the differences between the two groups in cell count-related indexes,cytokines,and acute-phase reactive proteins,and then these statistically significant different indexes were used as independent variables to be included in binary logistic regression analysis to screen out independent risk factors of lung cancer,and finally,receiver operating characteristic curve(ROC)was used to evaluate these risk factors' diagnostic value in the differentiation of malignant and benign lung nodules.Results:The number of nodules,nodule diameter,lobular sign,burr sign,vascular bundle sign,CT value,NLR,LMR,SII,IL-5,IL-2,IL-6,IL-1β,IL-10,IFN-γ,IL-8,IL-17,TNF-α,CRP,PCT,and SAA were statistically significantly different in benign and malignant lung nodules(P＜0.05).The result of binary logistic regression analysis showed the nodule diameter being 8-15 mm(OR=10.268,95％CI:1.719-61.321),nodule diameter being 15-30 mm(OR=59.194,95％CI:11.155-314.124),burr sign positive(OR=27.373,95％CI:3.901-192.055),LMR(OR=0.469,95％CI:0.282-0.779),IL-5(OR=1.557,95％CI:1.145-2.118),IL-2(OR=0.831,95％CI:0.748-0.924),SAA(OR=2.625,95％CI:1.407-4.897)and PCT(OR=1.763,95％CI:1.240-2.507)were related factors to differentiate benign and malignant nodules.Using ROC curve analysis,the AUC(95％CI)of nodule diameter,burr sign,LMR,IL-5,IL-2,SAA,and PCT for distinguishing benign and malignant nodules were 0.732(0.669-0.795),0.649(0.581-0.717),0.398(0.532-0.672),0.516(0.445-0.588),0.380(0.311-0.450),0.773(0.715-0.830),and 0.821(0.767-0.874),respectively.The AUC(95％CI)for distinguishing benign and malignant lung nodules by combined test metrics reached 0.983(0.971-0.995).Conclusion:The combination of serum inflammatory index and chest CT examination has good differential diagnostic value in distinguishing benign and malignant nodules.关键词
结节病,肺/中性粒细胞/淋巴细胞/单核细胞/C反应蛋白/降钙素原/体层摄影术,X线计算机Key words
Sarcoidosis,pulmonary/Neutrophil/Lymphocyte/Monocyte/C-reactive protein/Procalcitonin/Tomography,X-ray computed分类
医药卫生引用本文复制引用
徐思芸,陆霓虹..血清炎症指标联合胸部CT对良恶性肺结节的鉴别诊断价值[J].结核与肺部疾病杂志,2025,6(5):516-524,9.基金项目
国家自然科学基金(82460016) （82460016）
云南省科技厅科技计划项目(202303AC100026) （202303AC100026）
云南省教育厅科学研究基金(2023J0916) National Natural Science Foundation of China(82460016) （2023J0916）
Science and Technology Plan Project of Yunnan Provincial Department of Science and Technology(202303AC100026) （202303AC100026）
Yunnan Provincial Department of Education Science Research Fund Project(2023J0916) （2023J0916）
