摘要
目的 探究肺结节直径及实变肿瘤比等指标对早期浸润性肺癌(cT1aN0M0)淋巴结转移的预测价值,以指导术中淋巴结清扫方式的选择。方法 回顾性分析2022年1月-2023年12月在安徽医科大学第一附属医院接受单发肺结节手术切除,且术后病理证实为浸润性肺癌的患者502例,收集患者的临床资料、影像学资料及术后病理资料。按有无淋巴结转移分为两亚组,分别对组间人口学、影像学资料、术后病理资料进行对比,采用单因素和多因素Logistic回归探究肺结节直径及实变肿瘤比等指标与淋巴结转移之间的相关性,受试者工作(ROC)曲线探究结节直径及实变肿瘤比的临界值及诊断性能。结果 502例早期浸润性肺癌患者中,共有88例(17.5%)发现淋巴结转移,通过单因素及多因素分析显示肺结节直径、CEA、病理类型、脉管癌栓侵犯为淋巴结转移的独立影响因素,ROC曲线显示肺结节直径预测淋巴结转移的最大截止值为17.70mm。术前检查为部分实性结节的260例早期浸润性肺癌患者,共有28例(10.8%)存在淋巴结转移,通过单因素及多因素分析显示实变肿瘤比、肺结节直径、CEA、病理类型、脉管癌栓侵犯是淋巴结转移的独立影响因素。ROC曲线显示,肺结节直径、实变肿瘤比预测淋巴结转移的最大截止值分别为19.45 mm、0.717。结论 肺结节直径及实变肿瘤比可通过预测淋巴结转移有效指导肺结节患者术中是否需行系统性淋巴结清扫,CEA、病理类型、脉管癌栓侵犯可作为综合评估因素。
Objective To investigate the predictive value of pulmonary nodule diameter and consolidation to tumor ratio for lymph node metastasis in early invasive lung cancer(cT1aN0M0),and to guide the selection of intraoperative lymph node dissection.Methods A total of 502 patients who underwent surgical resection of a single pulmonary nodule in the First Affiliated Hospital of Anhui Medical University from January 2022 to December 2023 and were confirmed as invasive lung cancer by postoperative pathology were retrospectively analyzed.The clinical data,imaging data and postoperative pathological data of the patients were collected.The patients were divided into two subgroups according to the presence of lymph node metastasis.The demographic data,imaging data,and postoperative pathological data were compared between the two groups.The receiver operating characteristic(ROC) curve was used to explore the cut-off value and diagnostic performance of nodule diameter and consolidation to tumor ratio.Results Among 502 patients with early invasive lung cancer,88(17.5%) were found to have lymph node metastasis.Univariate and multivariate analysis showed that the diameter of lung nodule,CEA,pathological type and vascular tumor thrombus invasion were independent risk factors for lymph node metastasis.The ROC curve showed that the maximum cut-off value of lung nodule diameter for predicting lymph node metastasis was 17.70 mm.Among 260 patients with early invasive lung cancer who were diagnosed as PSNS preoperatively,28(10.8%) had lymph node metastasis.Univariate and multivariate analysis showed that,consolidation to tumor ratio,nodule diameter,CEA,pathological type,vascular tumor thrombus invasion were independent influencing factors of lymph node metastasis.The ROC curve showed that the maximum cut-off values of pulmonary nodule diameter and consolidation to tumor ratio for predicting lymph node metastasis were 19.45 mm and 0.717,respectively.Conclusion Nodule diameter and consolidation-to-tumor ratio can effectively guide the need fo
作者
金海洋
徐爱晖
JIN Haiyang;XU Aihui(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)
出处
《临床肺科杂志》
2024年第5期711-717,共7页
Journal of Clinical Pulmonary Medicine
关键词
肺结节直径
实变肿瘤比
浸润性肺癌
淋巴结转移
淋巴结清扫
Diameter of pulmonary nodule
Consolidation to tumor ratio
Invasive lung cancer
Lymph node metastasis
Lymph node dissection
