中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

T1 期肺腺癌患者淋巴结转移相关因素分析

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目的 探讨 T1 期肺腺癌患者的临床特征与淋巴结转移的关系。 方法 回顾性分析 2013 年 10 月至 2016 年 2月哈尔滨医科大学附属第二医院 253 例行肺叶切除术及系统性淋巴结清扫术 T1 期肺腺癌患者的临床资料,其中男 92 例、女 161 例,平均年龄(59.45±9.36)岁。分析影响淋巴结转移的独立因素。 结果 淋巴结转移阴性 182 例(71.9%),阳性 71 例(28.1%)。低分化(OR=6.988,P=0.001)、中分化(OR=3.589,P=0.008)、微乳头型(OR=24.000,P<0.001)、实性型(OR=5.080,P=0.048)、胸膜受侵(OR=2.347,P=0.024)、年龄≤53.5 岁(OR=2.594,P=0.020)均是影响淋巴结转移的独立风险因素。此外,肿瘤直径≥1.55 cm(OR=0.615,P=0.183),虽在截断值 1.55 cm 差异无统计学意义,仍可提示我们肿瘤直径是淋巴结转移的重要风险因素。 结论 在 T1 期肺腺癌中,肿瘤直径大、分化程度较低、实性成分百分比较大、病理亚型为微乳头型或实性型的侵袭性肺腺癌更易出现淋巴结转移。

Objective To investigate the relationship between clinical features and lymph node metastasis in lung adenocarcinoma patients with T1 stage. Methods We retrospectively analyzed the clinical data of 253 T1-stage lung adenocarcinoma patients (92 males and 161 females at an average age of 59.45±9.36 years), who received lobectomy and systemic lymph node dissection in the Second Affiliated Hospital of Harbin Medical University from October 2013 to February 2016. Results Lymph node metastasis was negative in 182 patients (71.9%) and positive in 71 (28.1%). Poor differentiation (OR=6.988, P=0.001), moderate differentiation (OR=3.589, P=0.008), micropapillary type (OR=24.000, P<0.001), solid type (OR=5.080, P=0.048), pleural invasion (OR=2.347, P=0.024), age≤53.5 years (OR=2.594, P=0.020) were independent risk factors for lymph node metastasis. In addition, in the tumor with diameter≥1.55 cm (OR=0.615, P=0.183), although the cut-off value of 1.55 cm had no significant difference, it still suggested that tumor diameter was an important risk factor of lymph node metastasis. Conclusion In lung adenocarcinoma with T1 stage, the large tumor diameter, the low degree of differentiation, the high ratio of consolidation, and the micropapillary or solid pathological subtypes are more prone to have lymph node metastasis.

关键词: 磨玻璃结节; 肺腺癌; 淋巴结转移; 实性成分百分比

Key words: Ground glass nodules; lung adenocarcinoma; lymph node metastasis; consolidation tumor ratio

引用本文: 尹纯同, 张春岩, 李华伟, 张晗, 郭聪颖, 张临友. T1 期肺腺癌患者淋巴结转移相关因素分析. 中国胸心血管外科临床杂志, 2018, 25(9): 755-761. doi: 10.7507/1007-4848.201710016 复制

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