Ⅰ期非小细胞肺癌血管浸润危险因素分析  

Analysis of risk factors for blood vessel invasion in stage Ⅰ non-small cell lung cancer

作　　者：尹立杰[1] 续蕊 颜珏[1] 强光亮[2] Yin Lijie;Xu Rui;Yan Jue;Qiang Guangliang(Department of Nuclear Medicine, China-Japan Friendship Hospital, Beijing 100029, China;Department of Thoracic Surgery, China-Japan Friendship Hospital, Beijing 100029, China)

机构地区：[1]中日友好医院核医学科,北京100029 [2]中日友好医院胸外科,北京100029

出　　处：《肿瘤研究与临床》2018年第12期838-841,共4页Cancer Research and Clinic

摘　　要：目的探讨Ⅰ期非小细胞肺癌(NSCLC)发生血管浸润的危险因素。方法回顾性分析中日友好医院2016年1月至2018年3月166例经手术完全切除并经病理确诊的Ⅰ期NSCLC患者临床资料,对肿瘤组织进行免疫组织化学染色,观察血管浸润发生情况。采用单因素分析与多因素logistic回归分析影响血管浸润的临床病理特征。对多因素分析有统计学意义的因素,通过受试者工作特征曲线分析诊断效率和最佳诊断界值。结果单因素分析提示血管浸润状态与吸烟史(P=0.020)、肿瘤最大标准化摄取值(SUVmax)(P=0.001)、肿瘤直径(P=0.001)、TNM分期(P=0.002)、淋巴管浸润(P=0.023)有关;多因素分析显示SUVmax是血管浸润的独立危险因素(OR=1.097,95%CI1.014~1.187,P=0.021)。术前肿瘤SUVmax可预测血管浸润,以4.85为界值时诊断效率最高,敏感度为66.0%,特异度为71.7%。结论原发肿瘤葡萄糖代谢情况对Ⅰ期NSCLC的血管浸润有独立预测价值,随着SUVmax的增加,血管浸润的发生风险升高。Objective To analyze the risk factors of blood vessel invasion in stage Ⅰ non-small cell lung cancer (NSCLC). Methods A retrospective analysis of 166 patients with stage Ⅰ NSCLC who underwent surgical resection and pathological diagnosis from January 2016 to March 2018 in China-Japan Friendship Hospital was conducted. The presence of blood vessel invasion in tumor tissue was detected by immunohistochemistry. Clinicopathological factors which may affect blood vessel invasion were evaluated by univariate analysis and multiple logistic regression analysis. For statistically significant factors revealed by multivariate analysis, the diagnostic efficiency and best cut-off point were calculated by the receiver operating characteristic curve. Results The univariate analysis identified that the smoking history (P = 0.020), maximum standardized uptake value (SUVmax) (P = 0.001), tumor diameter (P = 0.001), TNM stage (P = 0.002), and lymphatic invasion (P = 0.023) were factors affecting blood vessel invasion status. Multivariate analysis showed that SUVmax was an independent risk factor for blood vessel invasion (OR = 1.097, 95% CI 1.014-1.187, P = 0.021). The preoperative SUVmax of primary tumor was a predictor for blood vessel invasion with the highest diagnostic accuracy at a cut-off value of 4.85, the sensitivity and specificity were 66.0% and 71.7%, respectively. Conclusion The SUVmax is an independent predictor for blood vessel invasion in stage Ⅰ NSCLC, and the risk of blood vessel invasion rises with the increase of SUVmax.

关 键 词：癌 非小细胞肺 肿瘤侵润 血管浸润 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]