T2期非小细胞肺癌淋巴结转移的危险因素分析  

Analysis of risk factors for lymph node metastasis in T2 stage non-small cell lung cancer

作　　者：张弦飞 金润森[1] 郑宇彦 张亚杰[1] 韩丁培[1] 陈凯[1] 李鹤成[1] ZHANG Xianfei;JIN Runsen;ZHENG Yuyan;ZHANG Yajie;HAN Dingpei;CHEN Kai;LI Hecheng(Department of Thoracic Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,P.R.China)

机构地区：[1]上海交通大学医学院附属瑞金医院胸外科,上海200025

出　　处：《中国胸心血管外科临床杂志》2020年第10期1194-1200,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金青年基金(81702841);上海市卫生和计划生育委员会科研项目青年基金(20164Y0253);上海交通大学医学院高峰高原计划——“研究型医师”项目(20172005);上海市卫生和计划生育委员会上海市卫生系统优秀学科带头人项目(2017BR055)。

摘　　要：目的探索T2期非小细胞肺癌患者淋巴结转移的危险因素。方法回顾性分析2014~2017年在我院胸外科接受手术治疗的271例非小细胞肺癌患者的临床资料,其中男179例、女92例,平均年龄(62.73±0.58)岁。根据淋巴结转移情况将患者分为N0组、N1组和N2组。比较各组患者的临床资料。结果体重指数(P=0.043)、术前淋巴结肿大(P<0.001)、肿瘤直径(P<0.001)在不同组中的差异有统计学意义。其中,体重指数(OR=1.131,95%CI 1.001~1.277,P=0.048)和淋巴结肿大(OR=3.498,95%CI 1.666~7.342,P=0.001)是N2淋巴结转移的独立危险因素,而肿瘤直径是N1淋巴结转移(OR=1.538,95%CI 1.067~2.218,P=0.021)和N2淋巴结转移(OR=1.814,95%CI 1.196~2.752,P=0.005)的独立危险因素。结论体重指数较大或术前影像学发现淋巴结肿大的T2期非小细胞肺癌患者发生N2淋巴结转移可能性较大;而肿瘤直径较大的患者发生N1及N2淋巴结转移的可能性均较大。Objective To explore the risk factors for lymph node metastasis in patients with T2 stage non-small cell lung cancer.Methods The clinical data of 271 patients with non-small cell lung cancer who underwent surgical treatment in our hospital from 2014 to 2017 were collected,including 179 males and 92 females,with an average age of 62.73±0.58 years.The patients were divided into N0,N1,and N2 groups according to the lymph node metastasis status.The clinical data of the patients in different groups were compared.Results The body mass index(BMI,P=0.043),preoperative lymph node enlargement(P<0.001),and tumor diameter(P<0.001)were significantly different among groups.The BMI(OR=1.131,95%CI 1.001-1.277,P=0.048)and preoperative lymph node enlargement(OR=3.498,95%CI 1.666-7.342,P=0.001)were independent risk factors for N2 lymph node metastasis,and tumor diameter was an independent risk factor for both N1(OR=1.538,95%CI 1.067-2.218,P=0.021)and N2(OR=1.814,95%CI 1.196-2.752,P=0.005)lymph node metastasis.Conclusion Patients with high BMI or enlarged lymph nodes before surgery have a high risk for N2 lymph node metastasis,and those with large tumor diameter have a high risk for both N1 and N2 lymph node metastasis.

关 键 词：非小细胞肺癌 T2期 危险因素 手术 

分 类 号：R734.2[医药卫生—肿瘤]