目的 运用基于物联网数据挖掘技术的肺癌早期预警模型在丽水市慢性阻塞性肺疾病患者中进行早期肺癌筛查.方法 在 2021年 7 月到 2022 年 6 月在笔者医院确诊的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者行胸部 CT 平扫,将检出肺结节并同意入组的 300 名患者完成肺结节靶扫描+二三维重建,检测外周血 CYP1A1、GST及XRCC1 的基因多态性和miRNA130a和miR204-5p.嘱其 2022 年 7 月到 2022 年 9 月每天清醒时佩戴智能手环10h检测生命体征和运动量.2022 年 10 月复查肺结节靶扫描+二三维重建,如结节较前增大则如实告知患者结果,由患者与笔者医院除研究者外专科医师自行商议是否进行肺穿刺送病理.病理确诊肺癌的患者为进展组,其余为稳定组.结果 240 名患者为稳定组,48 名患者为进展组,12 名患者经与专科医师商议后继续随访.两组之间肥胖、平均血氧饱和度、最低血氧饱和度、用力肺活量(forced vital capacity,FVC)预计值、运动量、肺结节长径差异均有统计学意义(P<0.05).两组外周血miRNA-130a,miRNA-204-5p表达水平比较,差异有统计学意义(均P<0.001).稳定组与进展组外周血 CYP1A1、GST、XRCC1 基因型比较,差异均有统计学意义(P<0.05).受试者工作特征(receiver operating characteristic,ROC)曲线下面积分别为平均血氧饱和度 0.681,最低血氧饱和度 0.735,FVC预计值 0.781,运动量 0.835,肺结节长径 0.825,外周血miRNA-130a 0.796,miRNA-204-5p 0.893.结论 基于物联网数据挖掘技术的肺癌早期预警模型可用于慢性阻塞性肺疾病患者肺癌筛查.
Objective To use the Internet of things based early warning model of lung cancer to perform early lung cancer screening among chronic obstructive pulmonary disease(COPD)patients in Lishui City.Methods Patients with COPD diagnosed in our hospital from July 2021 to June 2022 underwent plain chest CT,and the 300 patients who had lung nodules detected and agreed to participate in the study were completed with lung nodule target scan + two-and three-dimensional reconstruction to detect gene polymorphisms of CYP1A1,GST and XRCC1 and mirna130a and mir204-5p in peripheral blood.Asked to wear smart hand ring for 10 hours every day while awake from July 2022 to September 2022 to detect vital signs and exercise volume.Review lung nodule target scan + two three dimensional reconstruction in October 2022.If the nodules were larger than before,the patient was truthfully informed of the results.The patient and the specialist of our hospital discussed whether to carry out lung puncture for pathology.Patients with pathologically confirmed lung cancer were progression group and the rest were stable group.Results Totally 240 patients were in the stable group,48 patients were in the progression group,12 patients continued to follow-up after consultation by physicians.There were significant differences in adiposity,mean oximetry,nadir oximetry,forced vital capacity(FVC)predicted,exercise capacity,and lung nodule diameter between the two groups.The expression levels of peripheral mirna-130a,mirna-204-5p were significantly different between the two groups(P<0.001).There were significant differences in CYP1A1,GST,and XRCC1 genotypes in peripheral blood between stable and progressive patients.The areas under the receiver operating characteristic(ROC)curves were mean oxygen saturation(0.681),lowest oxygen saturation(0.735),FVC predicted(0.781),exercise(0.835),lung nodule length diameter(0.825),peripheral blood mirna-130a(0.796),mirna-204-5p(0.893).Conclusion The Internet of things based early warning model for lung cancer can be used for lung cancer screening among COPD patients.
徐存来;曹卓;蒋奕薇;王欣;王馨怡
丽水市人民医院呼吸与危重症科,浙江丽水 323000丽水市人民医院呼吸与危重症科,浙江丽水 323000||温州医科大学第一临床医学院,浙江温州 325035
临床医学
肺结节;肺癌筛查;miRNA;物联网
Pulmonary nodule;Lung cancer screening;MiRNA;Internet of things
《中国现代医生》 2024 (002)
10-14 / 5
浙江省医药卫生计划项目(2021KY410,2023RC314)
10.3969/j.issn.1673-9701.2024.02.003
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