中文摘要：

目的 对检出直径〉8mm且无症状的孤立性肺结节进行临床风险评估,为临床诊断提供参考。方法 收集在医院经CT引导下经皮肺穿刺活检术确诊的孤立性肺结节患者697例的临床、病理与影像资料,其中无症状组患者326例与症状组患者371例。分析两组患者上述资料的差异。结果 326例无症状组患者平均年龄（55.49±11.95）岁,吸烟指数（34.21±22.64）包/年、结节大小（18.32±4.94）mm,显著低于症状组（57.42±11.09）岁,（42.66±41.39）包/年和（19.14±4.94）mm（P〈0.05）;无症状组癌症既往史、转移癌、良性病变中良性肿瘤以及Ⅲa期及之前的肺癌显著多于症状组（P〈0.05）。两组结节的边缘、密度、位置无显著性差异（P〉0.05）。结论 直径〉8mm的孤立性肺结节无症状并不意味着癌症风险降低,且患者更年轻、结节更小,吸烟指数更少,分期更早。临床上需高度重视此类肺结节,尽早明确诊断有助于改善肺癌的预后。

英文摘要：

Objective In recent years, the detection rate of pulmonary nodules is getting higher and higher. Nodules measuring 〉8mm show a significantly increased risk of malignancy, but the clinical and imaging characteristics of 〉8mm in asymptomatic solitary pulmonary nodules （SPNs） have not been reported detailed. Methods We retrospectively analyzed the clinical, imaging and pathological data with SPNs diagnosed by CT guided percutaneous lung biopsy in our hospital. They were classified into two groups, asymptomatic or symptomatic. The differences of above features between them were analyzed. Results From Jan of 2011 to April of 2015, 697 patients with SPNs were retrospectively reviewed. 326 were asymptomatic. Age, pack-years and size of nodules were significantly lower in asymptomatic group （55.49± 11.95y, 34.21±22.64 pack-years, 18.32±4. 4mm） than in symptomatic group （57.42±11.09y,42.66±41.39 packyears, 19.14± 4. 94mm, P〈0. 05）. In the asymptomatic group, the history of cancer, metastatic cancer, benign tumor in the benign lesions and IIIa or earlier stage of lung cancer were significantly more than in the symptomatic group （P〈0.05）. There was no significant difference in the edge, density and location of SPNs between the two groups. Conclusion The cancer risk of 〉8mm asymptomatic SPNs is not lower than symptomatic patients. The younger, smaller nodules, less pack-years and earlier stage of lung cancer were discovered in asymptomatic patients than in symptomatic patients with 〉8mm SPNs. It is necessary to pay attention to the 〉8mm asymptomatic SPNs in clinic. It is helpful to improve the prognosis of lung cancer.