title: [Study on solitary pulmonary nodules: correlation between diameter and clinical manifestation and pathological features].
abstract: OBJECTIVE
  Solitary pulmonary nodules (SPN) is a knotty problem in clinical work. The clinical manifestation and pathological features of SPN in sizes may be obviously different. The aim of this study is to analyze the relationship between the diameters and clinicopathologic characteristics of SPN.
  
  
  METHODS
  390 patients (212 male, 178 female, ranging from 17 years to 86 years, median age 57.1 years) with SPN who were postoperatively diagnosed by pathology between Jan. 2000 and Jun. 2009 are enrolled to this study. In these cases, the number of SPN diameters which are smaller than 0.5 cm (including 0.5 cm) (group A) is 16, between 0.5 cm and 1 cm (including 1 cm, not including 0.5 cm) (group B) is 58, between 1 cm and 2 cm (group C) is 163, and between 2 cm and 3 cm (group D) is 153. The clinical manifestation, and postoperative pathological characters are analyzed in various diameter ranges.
  
  
  RESULTS
  All procedures were carried out securely, including tumor enucleation (n = 20), wedge resection (n = 153), lobectomy (n = 217). There are 130 benign cases (33.3%) and 260 malignant cases (66.7%). 58.5% SPN are detected incidently with no symptoms. There is an increasing incidence of clinical symptoms as the increasing diameter of SPN. All the cases are divided into 4 groups, the prevalence of malignant are separated 43.7% (group A), 50.0% (group B), 63.2% (group C), 79.1% (group D). The diameter of SPN is positively correlated with incidence of malignancy (chi2 = 22.535, P < 0.001). Single factor analysis and Logistic regression analysis show the diameter of SPN is an independent risk factor of malignant pathology (OR = 1.922, P < 0.001). Fourteen patients in all of the SPN were followed up by 2 years or more before operation, and 10 of them turn out to be malignant at last. In the 14 patients, 7 cases were found not enlarged by CT scan, and 3 of them (42.9%) were malignant.
  
  
  CONCLUSIONS
  The diameter of SPN is highly associated with clinical symptoms, and is a significant risk factor to predict pathology. Early diagnosis and treatment is so important for patients with SPN.
authors.affiliation: Department of Thoracic Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Desong
authors.initials: D
authors.lastname: Yang
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Guanchao
authors.initials: G
authors.lastname: Jiang
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Li
authors.forename: Hui
authors.initials: H
authors.lastname: Zhao
authors.forename: Fan
authors.initials: F
authors.lastname: Yang
authors.forename: Yanguo
authors.initials: Y
authors.lastname: Liu
authors.forename: Zuli
authors.initials: Z
authors.lastname: Zhou
authors.forename: Liang
authors.initials: L
authors.lastname: Bu
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D003074:Solitary Pulmonary Nodule / Q000473:pathology* / Q000601:surgery