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多学科诊疗模式在鉴别良恶性肺结节中的价值研究
王伟华,刘樟林,曹捍波,郑逸华,林雪梅,毛晓明,周瑶瑶,徐利萍,杨俊飞,毛晓峰,林芳芳,江文洪
1.江山市人民医院;2.浙江省人民医院
摘要:
目的： 评估多学科诊疗（multidisciplinary diagnosis and treatment, MDT）模式在良恶性肺结节鉴别诊断和治疗中的应用价值。 方法 回顾性收集2019年1月至2024年2月江山市人民医院收治的201例患者临床资料，评估影响肺结节良恶性的独立危险因素，并计算MDT模式预测肺结节良恶性的准确度和一致性。 结果 MDT模式在肺癌诊断中表现出高灵敏度（0.949）、特异度（0.818）、阳性预测值（0.979）和诊断准确度（0.929），这些指标均高于胸部CT对肺结节的常规诊断。肺结节的直径（OR=1.12，95%CI：1.00~1.25，P=0.045）和密度(混杂磨玻璃（OR=8.33，95%CI：2.37~29.26，P<0.001）；纯磨玻璃（OR=5.94，95%CI：1.85~19.08，P=0.003）是恶性肺结节的独立风险因素。 结论 MDT模式在肺结节良恶性的鉴别诊断和治疗中发挥了重要作用，尤其在提高肺癌诊断准确性方面。
关键词:  多学科诊疗模式  肺结节  诊断  治疗  准确性
DOI：
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基金项目:浙江省医学会临床医学科研专项资金项目2018ZYC-A142
The role of multidisciplinary diagnosis and treatment for discriminating benign and malignant pulmonary nodules
wangweihua1,2,3, liuzhanglin4,5,5,5,6,7,5,5,5,6,3, caohanbo8, zhengyihua1,2,3, linxuemei1,2,3, maoxiaoming1,2,3, 周瑶瑶1,2,3, xuliping1,2,3, yangjunfei1,2,3, maoxiaofeng1,2,3, linfangfang1,2,3, jiangwenhong1,2,3
1.Jiangshan People'2.'3.s Hospital;4.Jiangshan People&5.amp;6.#39;7.&8.Zhejiang Provincial People’s Hospital
Abstract:
Objective: To evaluate the role of the multidisciplinary diagnosis and treatment (MDT) approach in distinguishing benign and malignant pulmonary nodules. Methods Clinical data from 201 patients admitted to Jiangshan People's Hospital between January 2019 and February 2024 were retrospectively collected to assess independent risk factors influencing the benign or malignant nature of pulmonary nodules as well as analyze the accuracy and concordance of the MDT model in predicting nodule benignity or malignancy. Results The MDT model demonstrated high sensitivity (0.949), specificity (0.818), positive predictive value (0.979), and diagnostic accuracy (0.929) in lung cancer diagnosis, all exceeding conventional chest CT diagnosis. Lung nodule diameter (OR=1.12, 95% CI: 1.00–1.25, P=0.045) and density (mixed ground-glass opacity [OR=8.33, 95% CI: 2.37–29.26, P<0.001); Pure ground-glass opacity (OR=5.94, 95% CI: 1.85–19.08, P=0.003) were independent risk factors for malignant pulmonary nodules. Conclusion The MDT model plays a significant role in differentiating malignant from benign pulmonary nodules, particularly in enhancing the accuracy of lung cancer diagnosis.
Key words:  Multidisciplinary diagnosis and treatment  Pulmonary nodules  diagnosis  treatment  accuracy