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 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。回归分析影响淋巴结转移的独立因素。 结果 淋巴结转移阴性 182(71.9%),阳性 71(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=24.00,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 无明显统计学差异,但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 explored independent related factors affectted lymph node metastasis and retrospectivly analyse 253 (92 males and 161 females) lobectomy and systemic lymph node dissection patients in lung adenocarcinoma patients with T1 stage. Results Lymph node metastasis was negative in 182 patients (71.9%), positive in 71 (28.1%). Poorly differentiated (OR=6.988, P=0.001), Moderately differentiated (OR=3.589, P=0.008), Micropapillary type (OR=24.00, 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) are independent risk factors for lymph node metastasis. In addition, the tumor diameter≥1.55 cm (OR=0.615, P=0.183), although the cut-off value of 1.55 cm had no significant statistical differences, but still suggest that tumor diameter was an important risk factor for lymph node metastasis. Conclusion In lung adenocarcinoma with T1 stage, the tumor diameter is larger, the degree of differentiation is lower, the ratio of consolidation tumor is larger, and the pathological subtypes are micropapillary or solid 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

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