摘要
目的探讨临床ⅠA期肺腺癌发生淋巴结转移的危险因素。方法分析新疆医科大学第一附属医院胸外科2021年12月至2022年8月完成解剖性肺叶切除+系统性淋巴结清扫手术的199例临床ⅠA期肺腺癌患者的临床资料。根据病理结果分为淋巴结转移组46例, 非淋巴结转移组153例。采用单因素分析和二元Logistic回归分析临床ⅠA期肺腺癌发生淋巴结转移的危险因素。结果纳入199例临床ⅠA期肺腺癌患者中男86例(43.2%), 女113例(56.8%), 中位年龄57(52, 64)岁。单因素分析结果显示, 淋巴结转移组在术前癌胚抗原(CEA)水平(2.5 ng/ml比1.6 ng/ml, Z=-4.446, P<0.01)、CT肿瘤直径(2.38 cm比1.57 cm, Z=-6.952, P<0.01)、实性成分比例(CTR)(1.00比0.00, Z=-9.542, P<0.01)方面高于非淋巴结转移组, 两组之间在分化程度(χ2=38.271)、病理亚型(χ2=105.757)、经肺泡腔内气道播散(STAS)(χ2=47.276)、脉管瘤栓(χ2=16.358), 肿瘤部位(χ2=26.985)、分叶征(χ2=34.037)、毛刺征(χ2=15.575)、血管集束征(χ2=5.534)、胸膜牵拉征(χ2=9.883)等方面差异有统计学意义(P<0.05);二元Logistic回归分析结果显示, 组间在微乳头和实性为主型[比值比(OR)=156.209, P<0.05]、STAS(OR=16.633, P<0.05)、CT肿瘤直径(OR=23.946, P<0.05)等方面差异有统计学意义。结论微乳头和实性为主型、STAS、较大的CT肿瘤直径是临床ⅠA期肺腺癌发生淋巴结转移的独立危险因素。
Objective To investigate the risk factors of lymph node metastasis in clinicalⅠA stage in lung adenocarcinoma.Methods The clinical data of 199 patients with clinicalⅠA stage in lung adenocarcinoma who underwent anatomical lobectomy and systematic lymph node dissection in the Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University from December 2021 to August 2022 were retrospectively analyzed.According to the pathological results,they were divided into lymph node metastasis group(n=46)and non-lymph node metastasis group(n=153).Univariate analysis and binary Logistic regression analysis were used to analyze the risk factors of lymph node metastasis in clinicalⅠA stage in lung adenocarcinoma.Results A total of 199 patients with clinicalⅠA stage in lung adenocarcinoma were enrolled,including 86 males(43.2%)and 113 females(56.8%),with a median age of 57(52,64)years.Univariate analysis showed that the level of preoperative carcinoembryonic antigen(CEA)(2.5 ng/ml vs.1.6 ng/ml,Z=-4.446,P<0.01),CT tumor diameter(2.38 cm vs.1.57 cm,Z=-6.952,P<0.01)and consolidation tumor ratios(CTR)(1.00 vs.0.00,Z=-9.542,P<0.01)in the lymph node metastasis group were higher than the non-lymph node metastasis group.Between the two groups,the differentiation degree(χ2=38.271),pathological subtype(χ2=105.757),spread through air spaces(STAS)(χ2=47.276),vascular tumor thrombus(χ2=16.358),tumor location(χ2=26.985),lobulation sign(χ2=34.037),spiculation sign(χ2=15.575),vascular convergence sign(χ2=5.534),pleural traction sign(χ2=9.883)were statistically significant(P<0.05).Binary Logistic regression analysis showed that there were significant differences between the two groups in micropapillary and solid subtype[odds ratio(OR)=156.209,P<0.05],CT tumor diameter(OR=23.946,P<0.05),STAS(OR=16.633,P<0.05).Conclusion Micropapillary and solid subtype,STAS and larger tumor diameter on CT are independent risk factors for lymph node metastasis in clinicalⅠA stage in lung adenocarcinoma.
作者
胡义
阿卜拉·努尔麦麦提
穆热迪力·麦麦提阿卜杜拉
张力为
宗亮
张海平
Hu Yi;Abla·Nurmamat;Muradil·Mamatabdulla;Zhang Liwei;Zong Liang;Zhang Haiping(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《中华实验外科杂志》
CAS
北大核心
2023年第8期1491-1493,共3页
Chinese Journal of Experimental Surgery
关键词
肺腺癌
淋巴结转移
危险因素
Lung adenocarcinoma
Lymph node metastasis
Risk factors
