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.	欧兆荣, 陶连琴, 时国朝, 等.孤立性肺结节的影像学特征及两种肺癌预测模型的比较.中国呼吸与危重监护杂志, 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.	中国抗癌协会肺癌专业委员会, 吴一龙, 蒋国樑, 等.孤立性肺结节的处理.循证医学, 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.肺癌的性别差异及机制.中国肺癌杂志, 2011, 14:625-630.
11.	陈灏珠, 林果为, 戴自英, 等.实用内科学.第13版.北京:人民卫生出版社, 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.	袁涛, 于铁链.非典型肺转移瘤的放射学表现.国外医学(临床放射学分册), 2003, 26:190-191.
15.	Pirozynski M.100 years of lung cancer.Respir Med, 2006, 100:2073-2084.
16.	王冬梅, 李为民, 李静, 等.吸烟与肺癌关系的Meta分析.中国呼吸与危重监护杂志, 2009, 8:229-233.
17.	李志忠, 王乐强, 庄洪洁.吸烟与肺癌类型关系的探讨.中华流行病学杂志, 2002, 13:369.
18.	赵宁, 俞顺章.我国吸烟与肺癌关系的Meta-analysis:15个病例对照研究的合并分析.中华流行病学杂志, 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. 欧兆荣, 陶连琴, 时国朝, 等.孤立性肺结节的影像学特征及两种肺癌预测模型的比较.中国呼吸与危重监护杂志, 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. 中国抗癌协会肺癌专业委员会, 吴一龙, 蒋国樑, 等.孤立性肺结节的处理.循证医学, 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.肺癌的性别差异及机制.中国肺癌杂志, 2011, 14:625-630.
11. 陈灏珠, 林果为, 戴自英, 等.实用内科学.第13版.北京:人民卫生出版社, 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. 袁涛, 于铁链.非典型肺转移瘤的放射学表现.国外医学(临床放射学分册), 2003, 26:190-191.
15. Pirozynski M.100 years of lung cancer.Respir Med, 2006, 100:2073-2084.
16. 王冬梅, 李为民, 李静, 等.吸烟与肺癌关系的Meta分析.中国呼吸与危重监护杂志, 2009, 8:229-233.
17. 李志忠, 王乐强, 庄洪洁.吸烟与肺癌类型关系的探讨.中华流行病学杂志, 2002, 13:369.
18. 赵宁, 俞顺章.我国吸烟与肺癌关系的Meta-analysis:15个病例对照研究的合并分析.中华流行病学杂志, 1993, 14:350-354.

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

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