Cardio-thoracic Surgery
Risk factors for lymph node metastasis in clinical ⅠA stage in lung adenocarcinoma
Hu Yi, Abla· Nurmamat, Muradil· Mamatabdulla, Zhang Liwei, Zong Liang, Zhang Haiping
Published 2023-08-08
Cite as Chin J Exp Surg, 2023, 40(8): 1491-1493. DOI: 10.3760/cma.j.cn421213-20221212-00894
Abstract
ObjectiveTo investigate the risk factors of lymph node metastasis in clinical ⅠA stage in lung adenocarcinoma.
MethodsThe clinical data of 199 patients with clinical ⅠA stage in lung adenocarcinoma who underwent anatomical lobectomy and systematic lymph node dissection in the Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University from December 2021 to August 2022 were retrospectively analyzed. According to the pathological results, they were divided into lymph node metastasis group (n=46) and non-lymph node metastasis group (n=153). Univariate analysis and binary Logistic regression analysis were used to analyze the risk factors of lymph node metastasis in clinical ⅠA stage in lung adenocarcinoma.
ResultsA total of 199 patients with clinical ⅠA stage in lung adenocarcinoma were enrolled, including 86 males (43.2%) and 113 females (56.8%), with a median age of 57 (52, 64) years. Univariate analysis showed that the level of preoperative carcinoembryonic antigen (CEA) (2.5 ng/ml vs. 1.6 ng/ml, Z=-4.446, P< 0.01), CT tumor diameter (2.38 cm vs. 1.57 cm, Z=-6.952, P< 0.01) and consolidation tumor ratios (CTR) (1.00 vs. 0.00, Z=-9.542, P< 0.01) in the lymph node metastasis group were higher than the non-lymph node metastasis group. Between the two groups, the differentiation degree (χ2=38.271), pathological subtype (χ2=105.757), spread through air spaces (STAS) (χ2=47.276), vascular tumor thrombus (χ2=16.358), tumor location (χ2=26.985), lobulation sign (χ2=34.037), spiculation sign (χ2=15.575), vascular convergence sign (χ2=5.534), pleural traction sign (χ2=9.883) were statistically significant (P< 0.05). Binary Logistic regression analysis showed that there were significant differences between the two groups in micropapillary and solid subtype [odds ratio (OR)=156.209, P< 0.05], CT tumor diameter (OR=23.946, P< 0.05), STAS (OR=16.633, P< 0.05).
ConclusionMicropapillary and solid subtype, STAS and larger tumor diameter on CT are independent risk factors for lymph node metastasis in clinical ⅠA stage in lung adenocarcinoma.
Key words:
Lung adenocarcinoma; Lymph node metastasis; Risk factors
Contributor Information
Hu Yi
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Abla· Nurmamat
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Muradil· Mamatabdulla
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Zhang Liwei
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Zong Liang
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
Zhang Haiping
Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
