早期孤立性肺腺癌患者淋巴结转移风险因素及与PET-CT摄取的关系研究  

Risk Factors of Lymph Node Metastasis and Relationship with PET-CT Uptake in Patients with Early Solitary Lung Adenocarcinoma

作　　者：张帆[1] 潘昭锦 李利军[1] 聂志鸿[1] 李大军[1] 乔保安[1] ZHANG Fan;PAN Zhao-jin;LI Li-jun;NIE Zhi-hong;LI Da-jun;QIAO Bao-an(Department of Thoracic Surgery,Jiyuan People's Hospital,Jiyuan 459000,Henan Province,China)

机构地区：[1]济源市人民医院胸外科,河南济源459000

出　　处：《罕少疾病杂志》2023年第1期37-38,共2页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨早期孤立性肺腺癌患者淋巴结转移(LNM)风险因素及与正电子发射断层成像-X线计算机断层成像(PET-CT)摄取的关系。方法 纳入2015年1月至2021年9月于我院行手术治疗临床组织分期(cT)1期孤立性肺腺癌患者共251例,根据病理淋巴结(pN)分期划分为NO组(225例)、N1组(16例)及N2组(10例),分析临床病理资料及术前薄层CT检查资料,采用多因素Logistic回归模型评价患者LNM发生独立危险因素及与最大标准摄取值(SUVmax)的相关性。结果 单因素分析结果 显示,病灶最大径、磨玻璃结节类型、血CEA水平及腺癌病理组织学类型均与早期孤立性肺腺癌患者LNM发生有关(P<0.05);多因素Logistic回归模型分析结果 显示,混合型磨玻璃结节、实性磨玻璃结节、血CEA水平>5ng/mL、腺泡型肺腺癌、乳头状/微乳头状浸润型肺腺癌及实体型肺腺癌均是早期孤立性肺腺癌患者LNM发生独立危险因素(P<0.05)。单因素分析结果 显示,早期孤立性肺腺癌患者LNM发生与SUVmax有关(P<0.05);多因素Logistic回归模型分析结果 显示,SUVmax>5是早期孤立性肺腺癌患者LNM发生独立危险因素(OR=3.42,95%CI:1.40~10.68,P=0.00)。结论 早期孤立性肺腺癌患者LNM发生与磨玻璃结、血CEA水平及病理组织学类型关系密切;同时PET-CT检查SUVmax>5者更易出现淋巴结转移。Objective To investigate the risk factors of lymph node metastasis and relationship with PET-CT uptake in patients with early solitary lung adenocarcinoma.Methods 251 isolated lung adenocarcinoma patients with cT1 stage treated by surgery were chosen in the period from January 2015 to September 2021 in our hospital.All patient were grouped according to pN stage and divided into N0 group(225 cases),N1 group(16 cases)and N2 group(10 cases).The clinicopathological data and preoperative thin-layer CT findings were analyzed.Multivariate logistic regression model was used to evaluate the independent risk factors of LNM and its correlation with SUVmax.Results Univariate analysis showed that the maximum diameter of the lesion,the ground glass nodule type,the level of serum CEA and the histopathological type of adenocarcinoma were all related to the occurrence of LNM in patients with early isolated lung adenocarcinoma(P<0.05).Multivariate logistic regression analysis showed that mixed ground glass nodules,solid ground glass nodules,blood CEA level>5ng/mL,acinar lung adenocarcinoma,papillary/micro papillary invasive lung adenocarcinoma and solid lung adenocarcinoma were independent risk factors for LNM in patients with early isolated lung adenocarcinoma(P<0.05).Univariate analysis showed that the occurrence of LNM in patients with early isolated lung adenocarcinoma was related to SUVmax(P<0.05).Multivariate logistic regression analysis showed that SUVmax>5 was the independent risk factor for LNM in patients with early isolated lung adenocarcinoma(P<0.05).Conclusion The occurrence of LNM in patients with early isolated lung adenocarcinoma is closely related to ground glass node,blood CEA level and histopathological type and those patients with SUVmax>5 by PET-CT were more likely to have lymph node metastasis.

关 键 词：孤立性结节 非小细胞肺癌 腺癌 淋巴结转移 PET-CT 

分 类 号：R734.2[医药卫生—肿瘤]