T1期肺腺癌患者淋巴结转移相关因素分析  

Related factors of lymph node metastasis in lung adenocarcinoma patients with T1 stage

作　　者：尹纯同 张春岩 李华伟 张晗 郭聪颖[1] 张临友[1] YIN Chuntong;ZHANG Chunyan;LI Huawei;ZHANG Han;GUO Congying;ZHANG Linyou(Department of Thoracic Surgery,The Second Affiliated Hospital of Harbin Medical University,Harbin,150086,P.R.China;Department of Thoracic Surgery,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang,453000,Henan,P.R.China)

机构地区：[1]哈尔滨医科大学附属第二医院胸外科,哈尔滨150086 [2]新乡医学院第一附属医院胸外科,河南新乡453000

出　　处：《中国胸心血管外科临床杂志》2018年第9期755-761,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：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 

分 类 号：R734.2[医药卫生—肿瘤]