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@#Objective To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.
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ObjectiveTo understand the prevalence of maternal anemia and iron deficiency during the second and third trimesters and their relationship with adverse pregnant outcomes.MethodsData of 3 262 gravidas, who received prenatal care and delivered at Drum Tower Hospital from October 1, 2013 to October 31, 2014, were retrospectively collected and analyzed. Blood routine test was performed for all subjects both at the second (20-22 weeks) and third trimesters (38 weeks of gestation or before delivery) using automatic blood analyzer. Moreover, serum ferritin level was determined at the second trimester with microparticle chemiluminescence immunoassay. Treatment was offered to those diagnosed as iron deficiency anemia or severe iron deficiency, and the adverse pregnancy outcomes were analyzed.Chi-square test and TrendChi-square test were performed for statistics.Results(1) Out of the 3 262 women, 601 (18.42%) were diagnosed as anemia at second trimester, among which 444 (73.88%) recovered at the third trimester after proper treatment. However, there were 285 (8.74%) new-onset anemia pregnancies at last trimester. Thus, the total prevalence of anemia in pregnancy was 27.16% (886/3 262). (2) The mean serum ferritin level at the second trimester was (29.40± 30.12) ng/ml, and 1 565 (47.98%) were diagnosed as iron deficiency at the same period. (3) During the mid-term pregnancies, 345 iron deficiency anemic women were identified, which accounted for 57.40% of all anemic cases in this study. Two hundred and fifty out of the 345 women were cured at the third trimester. However, another 206 new-onset iron deficiency anemic pregnancies were identified at the third trimester. For iron deficiency anemia both at mid- and late-term pregnancy, the prevalence was 16.89% (551/3 262), which accounted for 62.19% (551/886) of all anemic patients. (4) There were more women with microcytic hypochromic anemia in the late-trimester than in the mid-trimester [19.93%(60/301) vs 4.93% (17/345),χ2=34.478,P<0.01]. (5) Among women with serum ferritin≥30,≥20- <30,≥10- <20- <10 ng/ml, the prevalence of mild anemia in mid-trimester was 13.33%(142/1 065), 14.40%(91/632), 14.71%(130/884) and 24.82%(169/681), the prevalence of new-onset anemia in the third trimester was 3.94%(42/1 065), 5.85%(37/632), 12.78%(113/884), and 13.66%(93/681) respectively. The lower the serum ferritin level, the higher the prevalence of anemia in the mid-trimester (χ2trend=30.697,P<0.01) and the new-onset anemia in the last trimester (χ2trend=69.871,P<0.01). (6) The incidence of postpartum hemorrhage in pregnancies with serum ferritin level at≥10 but <20 ng/ml was significantly higher than those normal one [20.39%(52/255) vs 11.92%(75/629),χ2=10.577,P<0.01]. Neither serum ferritin level nor anemia was associated with other adverse pregnancy outcomes.ConclusionsThe incidences of anemia and iron deficiency remain at a high level at the second and third trimesters. The lower the serum ferritin level at mid-trimester, the higher the incidence of anemia.