CAJ | 학술논문

目的探讨应用最大似然法对周围型肺癌、良性肿瘤、结核球及炎性结节4种孤立性肺结节的诊断价值.方法选择60例孤立性肺结节做为研究对象,所有病例均经手术或穿刺活检病理证实,其中周围型肺癌36例、良性肿瘤6例、结核球8例、炎性结节10例.所有病例分别采用最大似然法和常规阅片法进行分析判别.以病理及临床诊断为对照标准,将上述两种方法的诊断结果行统计学比较.结果最大似然法诊断正确率分别为周围型肺癌80.6%(29/36)、良性肿瘤83.3%(5/6)、结核球75.0%(6/8)及炎性结节80.0%(8/10),总平均诊断正确率为80.0%(48/60);常规阅片法诊断正确率分别为周围型肺癌69.4%(25/36)、良性肿瘤66.7%(4/6)、结核球62.5%(5/8)及炎性结节70.0%(7/10),总平均诊断正确率为68.3%(41/60);最大似然法总平均诊断正确率较常规阅片法高,但差异无统计学意义(χ2=1.89,P=0.167>0.05).结论与常规阅片法相比,最大似然法对4类SPN的诊断正确率均有所提高,虽然统计学无显著差异,但仍可用于指导日常阅片工作,特别是对于年轻医师或基层医院医师,可以弥补其经验不足.
목적탐토응용최대사연법대주위형폐암、량성종류、결핵구급염성결절4충고립성폐결절적진단개치.방법선택60례고립성폐결절주위연구대상,소유병례균경수술혹천자활검병리증실,기중주위형폐암36례、량성종류6례、결핵구8례、염성결절10례.소유병례분별채용최대사연법화상규열편법진행분석판별.이병리급림상진단위대조표준,장상술량충방법적진단결과행통계학비교.결과최대사연법진단정학솔분별위주위형폐암80.6%(29/36)、량성종류83.3%(5/6)、결핵구75.0%(6/8)급염성결절80.0%(8/10),총평균진단정학솔위80.0%(48/60);상규열편법진단정학솔분별위주위형폐암69.4%(25/36)、량성종류66.7%(4/6)、결핵구62.5%(5/8)급염성결절70.0%(7/10),총평균진단정학솔위68.3%(41/60);최대사연법총평균진단정학솔교상규열편법고,단차이무통계학의의(χ2=1.89,P=0.167>0.05).결론여상규열편법상비,최대사연법대4류SPN적진단정학솔균유소제고,수연통계학무현저차이,단잉가용우지도일상열편공작,특별시대우년경의사혹기층의원의사,가이미보기경험불족.
Objective To evaluate the value of the maximum likelihood method in differentiating the 4 kinds of SPN among peripheral lung carcinoma,benign tumors,tuberculomas,inflammatory nodules.Methods 60 cases of pathologically proved SPN were selected for studying objects,including 36 cases of peripheral carcinomas,6 benign tumors,8 tuberculomas,10 inflammatory nodules.All cases were analyzed with the maximum likelihood method and the traditional method,respectively.Comparison was made on diagnostic results from the use of traditional method and the maximum likelihood method.Results The diagnostic accuracy with the maximum likelihood method of peripheral lung carcinoma,benign tumor,tuberculoma,inflammatory nodule were 80.6%(29/36),83.3%(5/6),75.0%(6/8),80.0%(8/10),respectively.The mean accuracy was 80.0%(48/60). The diagnostic accuracy with the traditional diagnostic method of peripheral lung carcinoma,benign tumor,tuberculoma,inflammatory nodule were 69.4%(25/36),66.7%(4/6),62.5%(5/8),70.0%(7/10),respective-ly.The mean accuracy was 68.3%(41/60).Although the mean accuracy of former method was higher than the latter,there was no statistical difference(χ2=1.89,P=0.167>0.05).Conclusion The maximum likelihood method is a useful instrument for the statistical diagnosis of SPN,compared with the traditional method.Without statistically significance,it still can be applied to the daily routine study.