Value of preoperative serum vitamin A level in the prediction of benign and malignant pulmonary nodules
10.3760/cma.j.cn115624-20240529-00443
- VernacularTitle:术前血清维生素A水平在肺结节良恶性预测中的应用价值
- Author:
Lu LIU
1
;
Hang YU
;
Xinsheng ZHANG
;
Yong ZHANG
;
Qing XU
;
Yinghua LIU
Author Information
1. 解放军总医院第一医学中心营养科，北京 100853
- Keywords:
Pulmonary nodules;
Vitamin A;
Lung cancer;
Prediction
- From:
Chinese Journal of Health Management
2024;18(11):816-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of preoperative serum vitamin A level in the prediction of benign or malignant pulmonary nodules.Methods:It was a retrospective cohort study. A total of 1 224 patients who underwent surgery for pulmonary nodules at the General Hospital of the People′s Liberation Army from January 2016 to December 2018 were consecutively included. The demographic information, postoperative pathological results, pulmonary CT findings and preoperative serum vitamin A test results were collected. The preoperative serum vitamin A levels of patients with lung cancer and benign pulmonary nodules were compared pairwise using the χ2 test. Logistic regression analysis was used to analyze the relevant factors for the occurrence of lung cancer and a stratified analysis was performed too. Prediction models for the benignity or malignancy of pulmonary nodules were constructed based on the results of multivariate logistic regression analysis. The efficacy of the models was evaluated, and the optimal preoperative prediction model was determined. The application value of preoperative serum vitamin A levels in predicting the benignity or malignancy of pulmonary nodules was then analyzed. Results:Of the 1 224 patients, postoperative pathology confirmed 1 044 cases with lung cancer and 180 cases with benign pulmonary nodules. The mean preoperative serum vitamin A level of patients with lung cancer was significantly lower than that in patients with benign pulmonary nodules (0.90 vs 1.06 μmol/L) ( Z=-3.493; P<0.001). Preoperative serum vitamin A level was a negative related factor for the occurrence of lung cancer ( OR=0.663, 95% CI: 0.484-0.914) ( P=0.011). In patients aged<60 years ( OR=0.623, 95% CI: 0.428-0.912), male ( OR=0.649, 95% CI: 0.438-0.976), with a body mass index≥24 kg/m 2 ( OR=0.634, 95% CI: 0.420-0.974), no family history of tumors ( OR=0.634, 95% CI: 0.440-0.923), no smoking history ( OR=0.619, 95% CI: 0.412-0.941), no drinking history ( OR=0.625, 95% CI: 0.424-0.933), with pulmonary nodules measuring 1-3 cm in diameter ( OR=0.643, 95% CI: 0.455-0.920), and with solid pulmonary nodules ( OR=0.681, 95% CI: 0.466-1.001), the preoperative serum vitamin A levels were significantly negatively correlated with the occurrence of lung cancer (all P<0.05). The prediction model incorporating preoperative serum vitamin A, CT characteristics of pulmonary nodules (nodule diameter, density), and clinical characteristics (age, gender) showed the best predictive efficacy for the benignity or malignancy of pulmonary nodules (the area under the curve was 0.792). Conclusions:Among patients receiving surgical treatment for pulmonary nodules, the preoperative serum vitamin A level of patients with lung cancer is lower than that of patients with benign pulmonary nodules. The preoperative serum vitamin A level is a negative associated factor for the occurrence of lung cancer. A combined model incorporating the preoperative serum vitamin A level provides a good prediction of benign or malignant pulmonary nodules.
