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| Analysis of the risk factors for the treatment of pulmonary nodules by video-assisted thoracoscopic surgery and its effect on immune function |
| ZHOU Shengnian MA Dongchun CHEN Bing |
| Department of Thoracic Surgery, Anhui Provincial Chest Hospital, Anhui Province, Hefei 230022, China |
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Abstract Objective To explore and analyze the malignant risk factors of video-assisted thoracoscopic surgery (VATS) for small pulmonary nodules and its effect on immune function. Methods Eighty patients with small pulmonary nodules admitted to Anhui Provincial Thoracic Hospital from June 2016 to June 2018 were treated with VATS, and definite pathological diagnosis was obtained. The malignant risk factors of small pulmonary nodules were analyzed. After VATS treatment for both benign and malignant pulmonary nodules, the changes of immune function in perioperative period were compared. Results Age, nodule maximum diameter, spiculation sign, lobulation sign, pleural traction sign, cavity sign, vascular cluster sign and calcification sign were included in the Logistic regression analysis. The results showed that age, nodule maximum diameter, spiculation sign, lobulation sign and pleural traction sign could be used as independent correlative factors to judge the malignancy of pulmonary nodules (P ＜ 0.05). All the patients were operated smoothly, and no serious complications or deaths were found during the perioperative period. The levels of CD4+, CD8+, CD4+/CD8+ and natural killer cells decreased before and after operation for benign and malignant pulmonary nodules (P ＜ 0.05). Conclusion Age, maximum diameter of nodules, spiculation sign, lobulation sign and pleural traction are independent factors in the determination of malignant pulmonary nodules. VATS treatment of pulmonary nodules can inhibit the acute inflammatory response after operation, and does not have a strong inhibitory effect on the immune function of patients, with high safety.
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[1] 曾小飞，马瑞东，尚观胜，等.电视胸腔镜术在老年小结节非小细胞肺癌患者治疗中的应用研究[J].现代生物医学进展，2016，16（5）：890-891.
[2] 曹彬，郭万华，王文公.术前CT穿刺定位辅助电视胸腔镜手术治疗肺小结节的临床研究[J].现代医学，2014，42（8）：860-861.
[3] Liu L，Mei J，Pu Q，et al. Thoracoscopic bronchovascular double sleeve lobectomy for non-smal cell lung cancer [J]. Eur J Cardiothorac Surg，2014，46（3）：493-495.
[4] 李冬，沈琦斌，郑屹峰，等.肺部小结节胸腔镜术前CT引导下钩线穿刺定位的临床应用[J].浙江医学，2017，39（13）：123-124.
[5] Shi CZ，Zhao Q，Luo LP，et al. Size of solitary pulmonary nodule was the risk factor of malignancy [J]. J Thorac Dis， 2014，6（6）：668-676.
[6] Choi SM，Heo EY，Lee J，et al. Characteristics of benign solitary pulmonary nodules confirmed by diagnostic video-assisted thoracoscopic surgery [J]. Clin Respir J，2016，10（2）：181-188.
[7] 张皓，齐海，王磊，等.电视胸腔镜与开胸手术治疗非小细胞肺癌随机对照研究的系统评价和Meta分析[J].中国胸心血管外科临床杂志，2015，22（12）：1087-1094.
[8] Park TY，Park YS. Long-term respiratory function recovery in patients with stage Ⅰ lung cancer receiving video-assisted thoracic surgery versus thoracotomy [J]. J Thorac Dis， 2016，8（1）：161-168.
[9] 蒋彬，孙天宇，邓波，等.孤立性肺结节良、恶性危险因素分析和外科诊治[J].中国胸心血管外科临床杂志，2016， 23（7）：702-703.
[10] 李春仙，李美红，王峰.非小细胞肺癌患者血清可溶性B7-H4检测的临床意义[J].中国卫生检验杂志，2015， 25（10）：1582-1583.
[11] Gonzalez-Rivas D，Fieira E，elgado M，et al. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of nonsmall cell lung cancer [J] J Thorac Dis，2014，6（6）：641-648.
[12] 王友于，曾富春，丛伟，等.全胸腔镜与后外侧开胸手术对非小细胞肺癌患者炎症因子及免疫功能的影响[J].现代生物医学进展，2015，15（18）：3484-3486.
[13] 黄威，周逸鸣，姜格宁.CT引导下Hookwire定位肺部小病灶的临床应用及改进[J].中华胸心血管外科临床杂志，2015，31（6）：336-337.
[14] 徐宁，葛腾飞，汤磊.89例肺小结节的电视胸腔镜手术治疗分析[J].临床肺科杂志，2015，20（11）：2002-2003.
[15] 房芳，王松，刘玉莹.低剂量螺旋CT在中老年体检人群肺癌筛查的检出率与成本分析[J].中国老年学，2016，36（16）：4042-4044.
[16] 胡彬，李强.早期非小细胞肺癌个体化手术策略与术中冰冻病理的指导[J].中国肺癌杂志，2016，19（6）：364-367.
[17] 张荣葆，谭星宇，陈清，等.胸外科住院肺癌合并慢性阻塞性肺疾病的调查结果分析[J].中国肺癌杂志，2017， 20（3）：163-167.
[18] 高树庚，邱斌，郭晓彤，等.胸腔镜解剖性部分肺叶切除手术技巧[J].中华胸部外科电子杂志，2016，3（2）：122-124.
[19] 赵一菊，翟健坤，康东平，等.低剂量螺旋CT和痰液基薄层细胞学联合筛查社区肺癌高危人群的研究[J].中华疾病控制杂志，2016，20（5）：491-494.
[20] 任丹，涂启敏.电视胸腔镜术与开胸肺叶切除术对早期非小细胞肺癌患者炎症因子及免疫功能的影响[J].标记免疫分析与临床，2016，23（11）：1331-1332. |
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