实性成分≤2 cm的肺腺癌患者淋巴结转移的临床病理学特征及危险因素

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Abstract Objective To analyze the clinicopathological characteristics and risk factors of lymph node metastasis in lung adenocarcinoma whose solid components in pulmonary nodules are less than 2 centimeters in diameter.Methods The clinicopathological data on 340 patients who had received surgery in the First Medical Center of Chinese PLA General Hospital between January 2018 and January 2021 was analyzed retrospectively. The clinicopathological characteristics and risk factors of lymph node metastasis were analyzed.Results Of these patients, 31 were positive for lymph node metastasis (9.1% in the positive group) and 309 were negative (90.9% in the negative group). The proportion of tumor marker abnormalities, nodule diameters, and PET-CT standard uptake values in the positive group were significantly higher or larger than those in the negative group [22.6% vs. 4.5%, P<0.001; (17.77±3.11) mm vs. (12.10±) 5.21) mm, P<0.001; 4.83±4.36 vs. 2.53±3.15, P=0.017, respectively]. There were more subsolid (66% vs. 9.7%, P<0.001) nodules and regular nodules (25.8% vs. 54%, P=0.008) in the negative group, which also had more vacuoles (35.3% vs. 3.2%, P<0.001). The groups (5.77±1.05 vs. 5.14±1.28, P=0.008) and numbers (15.35±6.28 vs. 12.60±7.19, P=0.041) of lymph node dissections in the positive group surpassed those in the negative group respectively. In the positive group, more patients presented with visceral pleural invasion (54.8% vs. 34%, P=0.021), vascular infiltration (9.7% vs. 0, P<0.001), spread of tumors through air space (9.7% vs. 0.6%, P<0.001), poorly- differentiated tumors (19.4% vs. 5.5%, P=0.009) and tumors of a special pathological subtype (containing micropapillary or solid components) (71% vs. 14.2%, P<0.001), and the Ki-67 index was significantly higher than that in the negative group (19.54±13.68 vs. 10.70±14.16, P=0.013). Multivariate logistic regression analysis showed that the size of solid components (OR=1.712, P=0.040) and tumors of a special pathological subtype (containing micropapillary or solid components) (OR=39.809, P=0.002) were independent risk factors for lymph node metastasis.Conclusions In lung adenocarcinoma patients whose diameter of solid components in pulmonary nodules is less than 2 centimeters, lymph node metastasis is not rare. The diameter of solid components and a special pathological subtype (micropapillary or solid components) are independent risk factors. Systemic lymph node dissection should be performed and sublobectomy should be chosen with caution in such patients.

Key words： lung adenocarcinoma lymph node metastasis risk factor

Received: 10 June 2021

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	LIANG Chaoyang
	SHEN Leilei
	YUN Tianyang
	GUO Juntang
	LIU Yang

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LIANG Chaoyang,SHEN Leilei,YUN Tianyang等. Correlations between lung adenocarcinoma with a less-than-two-centimeter diameter of solid components in pulmonary nodules and lymph node metastasis[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(2): 134-139.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I2/134

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