Analysis of missed diagnosis,misdiagnosis and treatment outcome evaluation of pulmonary tuberculosis complicated with lung cancer by MSCT
Objective To investigate the missed diagnosis,misdiagnosis and treatment outcome of pulmonary tuberculosis complicated with lung cancer by multi-slice spiral CT(MSCT).Methods A tortal of 60 patients with pulmonary tuberculosis complicated with lung cancer admitted to Henan Chest Hospital from January 2018 to July 2023 were selected as the observation group,and 40 patients with simple pulmonary tuberculosis were selected as the control group.Clinical symptoms,imaging findings,missed diagnosis and misdiagnosis of patients in the two groups were analyzed.MSCT parameters and pulmonary function test results were compared between the two groups,and the correlation between MSCT parameters and pulmonary function parameters was analyzed.The patients in the observation group were followed up for prognosis,and the follow-up time was more than 3 years.The MSCT parameters of the poor prognosis group and the good prognosis group were compared,and the value of MSCT parameters in predicting the clinical efficacy of pulmonary tuberculosis complicated with lung cancer was analyzed by receiver characteristic curve(ROC)curve.Results In terms of clinical symptoms,the observation group had more patients with cough than the control group,and the difference was statistically significant(P＜0.05).In terms of imaging,calcification and cavitation in the observation group were lower than those in the control group,while foliation,burr sign and atelectasis were higher than those in the control group,the differences were statistically significant(P＜0.05).Lung cancer was missed in 6 cases and misdiagnosed in 10 cases.The total lung volume(Vin),total lung volume(Vex),lung volume ratio(Vex/Vin),mean lung density(MLDin),mean lung density(MLDex)and unit volume density at the end of deep inspiration in observation group were higher than those in control group,and the lung volume difference(VIN-VEX)was lower than those in control group.The differences were statistically significant(P＜0.05).Vin had the best correlation with total lung volume(TLC)and was positively correlated(r=0.75,P＜0.05);Vex had the best correlation with residual air volume(RV)and was positively correlated(r=0.84,P＜0.05);Vex/Vin had the best correlation with forced lung capacity(FVC)and was negatively correlated(r=-0.82,P＜0.05),Vin-Vex had the best correlation with FVC and was positively correlated(r=0.79,P＜0.05).Vin,Vex and Vex/Vin in the poor prognosis group were higher than those in the good prognosis group,and Vin-VEX was lower than those in the good prognosis group,the differences were statistically significant(P＜0.05).The area under the curve(AUC)values of Vin,Vex,Vex/Vin and Vin-VEx were 0.633,0.758,0.782 and 0.870,respectively.Sensitivity was 70.00%,47.50%,62.50%,92.50%,respectively.The specificity was 56.67%,95.00%,83.33%and 71.67%,respectively.Conclusion The missed diagnosis rate and misdiagnosis rate of MSCT for pulmonary tuberculosis complicated with lung cancer are low,and there is a good correlation between MSCT parameters and lung function,which has a certain value in predicting the therapeutic effect of patients.
pulmonary tuberculosis complicated with lung cancerMultislice spiral CTMissed diagnosis and misdiagnosisLung functioncorrelation
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