Purpose To explore the differences of clinical and CT features between peripheral lung sarcomatoid carcinoma(PLSC),solitary pulmonary lesion(SPL),and common non-small cell lung cancer(CNSCLC),and to improve the diagnostic accuracy of PLSC.Materials and Methods Thirty patients with pathologically confirmed PLSC(sarcomatoid carcinoma group)were enrolled,and 68 cases of SPL(pneumonia group)and 73 cases of CNSCLC(lung cancer group)were selected as the control group,the clinical and CT features of PLSC were compared with SPL and NSCLC,respectively.A binary Logistic regression model was constructed based on the above statistically different parameters,and the area under the curve was used to evaluate the diagnostic efficiency of the regression model.Results Compared with clinical features,the proportion of smokers in sarcomatoid carcinoma group was significantly higher than that in pneumonia group and lung cancer group.The proportion of patients with a family history of first-degree relative malignancy in the sarcomatoid carcinoma group was significantly higher than that in the pneumonia group.The incidence of respiratory symptoms in sarcomatoid carcinoma group was significantly higher than that in lung cancer group(x2=5.800-16.611,all P＜0.025).Compared with CT features,the incidence of extensive necrosis and circular enhancement in PLSC group were significantly higher than those in SPL and CNSCLC group,while ΔCT value of both arterial and venous phase in PLSC group were significantly lower than those in the other two groups.The incidence of lobulation and air bronchogram of PLSC group were significantly higher than those of SPL group,but the incidence of pleural attachment and linear enhancement around the necrotic area of PLSC group were significantly lower than that of SPL group.The longest diameter of lesion in PLSC group was significantly larger than that in lung CNSCLC group,and the incidence of necrosis was significantly higher than that CNSCLC cancer group(x2/Z=-5.784-31.877,all P＜0.025).Compared with SPL,family history of malignancy,presence of air bronchogram and circular enhancement,absence of pleural attachment,and lower ΔCT value of venous phase were independent predictors of PLSC.The area under the curve of this model was 0.975.Compared with CNSCLC,the presence of respiratory symptoms,larger lesion,and circular enhancement were independent predictors of PLSC,and the area under the curve of this model was 0.870.Conclusion The clinical and CT features of PLSC are significantly different from those of SPL and CNSCLC.Identifying these differences correctly can help improve the preoperative diagnostic accuracy and the prognosis of patients.

Purpose To explore the differences of clinical and CT features between peripheral lung sarcomatoid carcinoma(PLSC),solitary pulmonary lesion(SPL),and common non-small cell lung cancer(CNSCLC),and to improve the diagnostic accuracy of PLSC.Materials and Methods Thirty patients with pathologically confirmed PLSC(sarcomatoid carcinoma group)were enrolled,and 68 cases of SPL(pneumonia group)and 73 cases of CNSCLC(lung cancer group)were selected as the control group,the clinical and CT features of PLSC were compared with SPL and NSCLC,respectively.A binary Logistic regression model was constructed based on the above statistically different parameters,and the area under the curve was used to evaluate the diagnostic efficiency of the regression model.Results Compared with clinical features,the proportion of smokers in sarcomatoid carcinoma group was significantly higher than that in pneumonia group and lung cancer group.The proportion of patients with a family history of first-degree relative malignancy in the sarcomatoid carcinoma group was significantly higher than that in the pneumonia group.The incidence of respiratory symptoms in sarcomatoid carcinoma group was significantly higher than that in lung cancer group(x2=5.800-16.611,all P＜0.025).Compared with CT features,the incidence of extensive necrosis and circular enhancement in PLSC group were significantly higher than those in SPL and CNSCLC group,while ΔCT value of both arterial and venous phase in PLSC group were significantly lower than those in the other two groups.The incidence of lobulation and air bronchogram of PLSC group were significantly higher than those of SPL group,but the incidence of pleural attachment and linear enhancement around the necrotic area of PLSC group were significantly lower than that of SPL group.The longest diameter of lesion in PLSC group was significantly larger than that in lung CNSCLC group,and the incidence of necrosis was significantly higher than that CNSCLC cancer group(x2/Z=-5.784-31.877,all P＜0.025).Compared with SPL,family history of malignancy,presence of air bronchogram and circular enhancement,absence of pleural attachment,and lower ΔCT value of venous phase were independent predictors of PLSC.The area under the curve of this model was 0.975.Compared with CNSCLC,the presence of respiratory symptoms,larger lesion,and circular enhancement were independent predictors of PLSC,and the area under the curve of this model was 0.870.Conclusion The clinical and CT features of PLSC are significantly different from those of SPL and CNSCLC.Identifying these differences correctly can help improve the preoperative diagnostic accuracy and the prognosis of patients.

Purpose To explore the CT features of solid components between benign and malignant mixed ground-glass nodules(mGGO),and between minimally invasive adenocarcinoma(MIA)and invasive adenocarcinoma(IAC),and to improve the accuracy of preoperative diagnosis of mGGO.Materials and Methods The clinical and imaging data of 313 patients with mGGO admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to July 2022 were retrospectively analyzed,and all patients were divided into benign group(95 cases)and malignant group(218 cases)according to follow-up or pathological results.All patients in malignant group were further divided into MIA(118 cases)and IAC(100 cases)groups.Logistic regression analysis models were established using the statistically significant CT features above,and the area under the curve(AUC)was calculated to evaluate the effectiveness of the model.Results ① Comparison of clinical characteristics between benign and malignant groups:malignant mGGO were more common in older people,females and nonsmokers,without smoking history,and the differences between two groups were significantly different(Z=-3.776,χ2=13.587,19.257;all P<0.001).②Comparison of CT features between benign and malignant groups:benign group existed a higher proportion of single solid component(84.21%vs.55.50%),while malignant group existed a higher proportion of multiple solid components(44.50%vs.15.79%),and the difference between two groups was significantly different(χ2=23.728,P<0.001).As for patients with single solid component,the solid components in malignant group were more likely to be irregular,mostly with eccentric distribution,and the proportion of solid components connected with blood vessels and pleura were higher than the benign group,the differences between two groups were significant(χ2=23.785,5.025,7.264;all P<0.05).Meanwhile,the benign group also had higher CT value[-153.00(-254.00,-80.50)Hu vs.-265.00(-363.25,-122.00)Hu],while lower relative CT value(0.30±0.16 vs.0.41±0.22),the differences between two groups were significant(all P<0.001).Logistic regression analysis:irregular morphology of the solid component(OR=0.236,P<0.001)and higher CT value(OR=1.009,P<0.05)were independent predictors of malignant mGGO.Receiver operator characteristic(ROC)curve analysis showed that the AUC was 0.772,and its accuracy,sensitivity and specificity was 70.65%,74.40%and 65.00%,respectively.③Comparison of CT features between MIA and IAC groups:MIA group existed a higher proportion of single solid component(74.58%vs.33.00%),while IAC group existed a higher proportion of multiple solid components(67.00%vs.25.42%),and the difference between two groups was significantly different(χ2=37.885,P<0.001).As for patients with single solid component,the solid components in IAC group were more likely to be irregular,it also had higher area,area proportion,and CT value,while lower relative CT value than the MIA group,the differences between two groups were significant(χ2=7.563,Z=-4.388,-3.923,-3.996;all P<0.05).Logistic regression analysis:eccentric distribution of the solid component(OR=0.083,P<0.05)and large area(OR=1.063,P<0.05)were independent predictors of IAC.ROC curve analysis showed that the AUC was 0.865,and its accuracy,sensitivity and specificity was 83.47%,87.90%and 68.20%,respectively.Conclusion The solid components between benign and malignant nodules as well as between MIA and IAC show different CT features.Based on these different features,it's helpful to improve the preoperative diagnostic accuracy of mGGO and guide the clinical treatment plans.

BACKGROUND: Diabetic morbidity can predict its progress tendency. National diabetic morbidity has been increased compared with previous level at present.OBJECTIVE: To compare the diabetic morbidity between populations with impaired glucose tolerance or normal blood glucose tolerance to analyze its correlative influencing factors.DESIGN: A cluster sampling survey in two communities of Liuzhou City Guangxi Zhuang Autonomous Region based on adults.SETTING: Department of endocrinology in a university hospital.PARTICIPANTS: Diabetic morbidity was investigated in 4 relative big unit communities of Liuzhou City between July and August 1994. The resident population of the communities was 11 886, which were all adults between 20 and 75 years old and lived in Liuzhou City for more than 5 years. Populations with either impaired glucose tolerance or normal blood glucose tolerance in 2 of the 4 unit communities were followed up in October 1999. Totally 9 230 individuals should be checked and 6 020 subjects were actually checked with the response rate of 65.22% (quite a few cases lost followed up due to unemployment and retirement, etc. ) . Inclusion criteria: Finally 5 539 subjects with complete data of two surveys entered into statistics. There were 5 237 normal individuals and 266 individuals with impaired glucose tolerance. And there were 3 177 males including 110 individuals with impaired glucose tolerance with an average age of(40 ± 12) years old, and 2 362 females including 156 individuals with impaired glucose tolerance with an average age of(41 ± 10) years old. Exclusion criterion: secondary diabetes.METHODS: Totally 5 539 subjects(including individuals with normal blood glucose or impaired glucose tolerance) who confirmed without diabetes in 1994 survey for diabetic morbidity in 2 unit communities of Liuzhou City Gugangxi Zhuang Autonomous Region received recheck in 1999 including blood glucose, body mass index(BMI), blood pressure and blood fat to analyze the impacts of each factor on diabetic morbidity.bidity among correlative risk factors.RESULTS: Totally 5 539 individuals were included into statistics. A totally of 46 of 5 237 normal individuals developed diabetes with the annual percent of conversion of 0.19%, while 50 of 226 individuals with impaired glucose tolerance developed diabetes with the annual percent of conversion of 3.84%, which had 20.9 times of correlative risk significantly higher than normal individuals(x2 = 1 063.1, P < 0. 000 1).CONCLUSION: The risk of diabetes is higher in individuals with impaired glucose tolerance than normal individuals. Age, BMI, hypertension, fasting blood glucose, blood glucose, and 1 hour blood glucose in Glucose tolerance test are risk factors of diabetic morbidity.