Influencing factor analysis of malignancy rate of pulmonary nodules based on pathological outcomes and optimization of integrated management strategies_West China Medical Journal

Authors：

HU Xiaolan ^1,2 , ZHOU Ailing ^1,2 , SU Hongxia ² , ZHOU Yongzhao ¹ ,  MA Li ^1,2

1. Department of Outpatient, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

MA Li, Email: 1004500237@qq.com

Keywords：

Pathological outcomes; influencing factors; pulmonary nodules; integrated management

DOI：

10.7507/1002-0179.202401228

Video：

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Objective To analyze the benign-malignant outcomes of pulmonary nodules in surgical patients and their influencing factors, and provide evidence and ideas for optimizing and improving the integrated management model of pulmonary nodules. Methods From October to December 2023, a convenience sampling method was used to select patients who underwent lung surgery at West China Hospital, Sichuan University between July 2022 and June 2023 for this study. The malignancy rate of postoperative pathological results of pulmonary nodules and its influencing factors were analyzed using univariate analysis and multiple logistic regression. Results A total of 4600 surgical patients with pulmonary nodules were included, with a malignancy rate of 88.65% (4078/4600) and a benign rate of 11.35% (522/4600). Univariate analysis showed significant differences in malignancy rates among different genders, ages, methods of pulmonary nodule detection, and smoking histories (P<0.05); however, no significant difference was found regarding place of birth or family history of lung cancer (P>0.05). Multiple logistic regression analysis indicated that females [odds ratio (OR)=1.533, 95% confidence interval (CI) (1.271, 1.850)], older age groups [61-75 vs. ≤30 years: OR=1.640, 95%CI (1.021, 2.634); >75 vs. ≤30 years: OR=2.690, 95%CI (1.062, 6.814)], and pulmonary nodules detected during physical examinations [OR=1.286, 95%CI (1.064, 1.554)] were high-risk factors for malignancy, with statistical significance (P<0.05). Conclusion In the integrated management of pulmonary nodules, it is crucial not to overlook females or older patients, as they may be more significant influencing factors than smoking; furthermore, lung examinations are effective means of early detection of malignant lung tumors and are worth promoting and popularizing.

Citation： HU Xiaolan, ZHOU Ailing, SU Hongxia, ZHOU Yongzhao, MA Li. Influencing factor analysis of malignancy rate of pulmonary nodules based on pathological outcomes and optimization of integrated management strategies. West China Medical Journal, 2024, 39(4): 517-520. doi: 10.7507/1002-0179.202401228 Copy

1.	马俊彦. 多发性肺结节的临床特征及良恶性因素分析. 延安: 延安大学, 2023.
2.	王璐, 洪群英. 肺结节诊治中国专家共识(2018 年版)解读. 中国实用内科杂志, 2019, 39(5): 440-442.
3.	Patz EF, Pinsky P, Gatsonis C, et al. Overdiagnosis in low-dose computed tomography screening for lung cancer. JAMA Intern Med, 2014, 174(2): 269-274.
4.	刘丹, 黄燕, 周清华, 等. 肺结节/肺癌患者全程管理模式的设计与应用. 中国肺癌杂志, 2020, 23(5): 299-305.
5.	Fu Y, Liu J, Chen Y, et al. Gender disparities in lung cancer incidence in the United States during 2001-2019. Sci Rep, 2023, 13(1): 12581.
6.	Jemal A, Miller KD, Ma J, et al. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med, 2018, 378(21): 1999-2009.
7.	Mederos N, Friedlaender A, Peters S, et al. Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer. ESMO Open, 2020, 5(Suppl 4): e000796.
8.	Huang F, Pan B, Wu J, et al. Relationship between exposure to PM_2.5 and lung cancer incidence and mortality: a meta-analysis. Oncotarget, 2017, 8(26): 43322-43331.
9.	Kim C, Gao YT, Xiang YB, et al. Home kitchen ventilation, cooking fuels, and lung cancer risk in a prospective cohort of never smoking women in Shanghai, China. Int J Cancer, 2015, 136(3): 632-638.
10.	李纪宾, 邹小农. 全球癌症流行现状及环境致癌因素解析. 环境卫生学杂志, 2023, 13(11): 795-803.
11.	Strickler HD, Schiffman MH, Shah KV, et al. A survey of human papillomavirus 16 antibodies in patients with epithelial cancers. Eur J Cancer Prev, 1998, 7(4): 305-313.
12.	Randhawa S, Sferra SR, Das C, et al. Examining gender differences in lung cancer screening. J Community Health, 2020, 45(5): 1038-1042.
13.	张亚琛. 河北省肺癌和肺结节危险因素分析及风险评估模型的建立. 石家庄: 河北医科大学, 2018.
14.	Yu L, Zhang B, Zou H, et al. Multivariate analysis on development of lung adenocarcinoma lesion from solitary pulmonary nodule. Contrast Media Mol Imaging, 2022, 2022: 8330111.
15.	Gao JW, Rizzo S, Ma LH, et al. Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology. Transl Lung Cancer Res, 2017, 6(1): 68-75.
16.	廖俊蕾, 柳弥. 健康体检人群胸部低剂量螺旋 CT 确诊肺部结节及肺癌情况研究. 临床肺科杂志, 2020, 25(11): 1722-1724, 1728.
17.	林丹丹, 吴晓青, 刘婷, 等. 2082 例行肺部低剂量高分辨螺旋 CT 检查的健康体检者结果分析. 中华肺部疾病杂志(电子版), 2020, 13(5): 687-689.
18.	李梦乾, 张晓梅, 胡家蕊, 等. 孤立性肺结节良恶性预测模型的系统评价. 肿瘤预防与治疗, 2022, 35(4): 318-328.
19.	Siegfried JM. Sex and gender differences in lung cancer and chronic obstructive lung disease. Endocrinology, 2022, 163(2): bqab254.
20.	崔学容, 蒋幼凡. 慢性阻塞性肺疾病与肺癌发病关联性及其机制的研究进展. 现代临床医学, 2024, 50(1): 73-76.

1. 马俊彦. 多发性肺结节的临床特征及良恶性因素分析. 延安: 延安大学, 2023.
2. 王璐, 洪群英. 肺结节诊治中国专家共识(2018 年版)解读. 中国实用内科杂志, 2019, 39(5): 440-442.
3. Patz EF, Pinsky P, Gatsonis C, et al. Overdiagnosis in low-dose computed tomography screening for lung cancer. JAMA Intern Med, 2014, 174(2): 269-274.
4. 刘丹, 黄燕, 周清华, 等. 肺结节/肺癌患者全程管理模式的设计与应用. 中国肺癌杂志, 2020, 23(5): 299-305.
5. Fu Y, Liu J, Chen Y, et al. Gender disparities in lung cancer incidence in the United States during 2001-2019. Sci Rep, 2023, 13(1): 12581.
6. Jemal A, Miller KD, Ma J, et al. Higher lung cancer incidence in young women than young men in the United States. N Engl J Med, 2018, 378(21): 1999-2009.
7. Mederos N, Friedlaender A, Peters S, et al. Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer. ESMO Open, 2020, 5(Suppl 4): e000796.
8. Huang F, Pan B, Wu J, et al. Relationship between exposure to PM_2.5 and lung cancer incidence and mortality: a meta-analysis. Oncotarget, 2017, 8(26): 43322-43331.
9. Kim C, Gao YT, Xiang YB, et al. Home kitchen ventilation, cooking fuels, and lung cancer risk in a prospective cohort of never smoking women in Shanghai, China. Int J Cancer, 2015, 136(3): 632-638.
10. 李纪宾, 邹小农. 全球癌症流行现状及环境致癌因素解析. 环境卫生学杂志, 2023, 13(11): 795-803.
11. Strickler HD, Schiffman MH, Shah KV, et al. A survey of human papillomavirus 16 antibodies in patients with epithelial cancers. Eur J Cancer Prev, 1998, 7(4): 305-313.
12. Randhawa S, Sferra SR, Das C, et al. Examining gender differences in lung cancer screening. J Community Health, 2020, 45(5): 1038-1042.
13. 张亚琛. 河北省肺癌和肺结节危险因素分析及风险评估模型的建立. 石家庄: 河北医科大学, 2018.
14. Yu L, Zhang B, Zou H, et al. Multivariate analysis on development of lung adenocarcinoma lesion from solitary pulmonary nodule. Contrast Media Mol Imaging, 2022, 2022: 8330111.
15. Gao JW, Rizzo S, Ma LH, et al. Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology. Transl Lung Cancer Res, 2017, 6(1): 68-75.
16. 廖俊蕾, 柳弥. 健康体检人群胸部低剂量螺旋 CT 确诊肺部结节及肺癌情况研究. 临床肺科杂志, 2020, 25(11): 1722-1724, 1728.
17. 林丹丹, 吴晓青, 刘婷, 等. 2082 例行肺部低剂量高分辨螺旋 CT 检查的健康体检者结果分析. 中华肺部疾病杂志(电子版), 2020, 13(5): 687-689.
18. 李梦乾, 张晓梅, 胡家蕊, 等. 孤立性肺结节良恶性预测模型的系统评价. 肿瘤预防与治疗, 2022, 35(4): 318-328.
19. Siegfried JM. Sex and gender differences in lung cancer and chronic obstructive lung disease. Endocrinology, 2022, 163(2): bqab254.
20. 崔学容, 蒋幼凡. 慢性阻塞性肺疾病与肺癌发病关联性及其机制的研究进展. 现代临床医学, 2024, 50(1): 73-76.

West China Medical Journal

Influencing factor analysis of malignancy rate of pulmonary nodules based on pathological outcomes and optimization of integrated management strategies

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