title: Establishment of a mathematic model for predicting malignancy in solitary pulmonary nodules.
abstract: BACKGROUND
  The aim of this study was to establish a model for predicting the probability of malignancy in solitary pulmonary nodules (SPNs) and provide guidance for the diagnosis and follow-up intervention of SPNs.
  
  
  METHODS
  We retrospectively analyzed the clinical data and computed tomography (CT) images of 294 patients with a clear pathological diagnosis of SPN. Multivariate logistic regression analysis was used to screen independent predictors of the probability of malignancy in the SPN and to establish a model for predicting malignancy in SPNs. Then, another 120 SPN patients who did not participate in the model establishment were chosen as group B and used to verify the accuracy of the prediction model.
  
  
  RESULTS
  Multivariate logistic regression analysis showed that there were significant differences in age, smoking history, maximum diameter of nodules, spiculation, clear borders, and Cyfra21-1 levels between subgroups with benign and malignant SPNs (P<0.05). These factors were identified as independent predictors of malignancy in SPNs. The area under the curve (AUC) was 0.910 [95% confidence interval (CI), 0.857-0.963] in model with Cyfra21-1 significantly better than 0.812 (95% CI, 0.763-0.861) in model without Cyfra21-1 (P=0.008). The area under receiver operating characteristic (ROC) curve of our model is significantly higher than the Mayo model, VA model and Peking University People's (PKUPH) model. Our model (AUC =0.910) compared with Brock model (AUC =0.878, P=0.350), the difference was not statistically significant.
  
  
  CONCLUSIONS
  The model added Cyfra21-1 could improve prediction. The prediction model established in this study can be used to assess the probability of malignancy in SPNs, thereby providing help for the diagnosis of SPNs and the selection of follow-up interventions.
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Man
authors.initials: M
authors.lastname: Zhang
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhuo
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Zhanlin
authors.initials: Z
authors.lastname: Guo
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Xingguang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Zhao
authors.affiliation: 1 The First Clinical College, Southern Medical University, Guangzhou 510515, China ; 2 Department of Thoracic Surgery, 3 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China ; 4 School of Public Health, Inner Mongolia Medical University, Hohhot 010059, China ; 5 Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China ; 6 Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China ; 7 Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Jianxing
authors.initials: J
authors.lastname: He
keywords: Solitary pulmonary nodule (SPN); diagnosis; logistic model; malignant tumor; prediction