Predictors of lymph node metastasis and possible selective lymph node dissection in clinical stage IA non-small cell lung cancer
Predictors of lymph node metastasis and possible selective lymph node dissection in clinical stage IA non-small cell lung cancer
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DOI：
10.21037/jtd.2018.06.129
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发表时间：
2018-07-01
影响因子：
2.5
通讯作者：
Yuan, Ligong
中科院分区：
文献类型：
--
作者：
Ding, Ningning;Mao, Yousheng;Yuan, Ligong
背景资料：肺癌患者淋巴结的病理分期与术前预测的不同，对于临床诊断为IA期的非小细胞肺癌（non-small cell lung cancer，NSCLC）患者，很难预测淋巴结的转移情况。本研究旨在探讨临床IA期非小细胞肺癌患者的淋巴结转移模式及预测淋巴结转移的危险因素。回顾性分析我中心2013年7月至2017年6月诊断为临床IA期NSCLC的所有患者，共1例，543例接受解剖性肺叶切除术和系统性淋巴结清扫术的患者入组本研究。采用多因素Logistic回归分析淋巴结转移的危险因素，并根据原发肿瘤的部位，采用Fisher精确检验确定淋巴结转移的方式。63例患者表现为N1疾病，17例患者仅表现为跳过的N2疾病，51例患者同时具有N1和N2阳性淋巴结。单纯磨草样阴影（GGO）患者无淋巴结转移。当患者被随机分为六组，
Background: The pathologic stages of lymph nodes usually differ from preoperatively predicted in lung cancers and it is difficult to predict the metastasis of lymph nodes for the patients diagnosed as clinical stage IA non-small cell lung cancers (NSCLC). This study aimed to investigate the patterns of lymph node metastasis and the risk factors predicting lymph node metastasis in the patients with clinical stage IA NSCLCs.Methods: All patients diagnosed as clinical stage IA NSCLC from July 2013 to June 2017 in our center were retrospectively reviewed, and a total number of 1,543 patients who underwent anatomical lobectomy with systematic lymph node dissection were enrolled in this study. Multivariate logistic regression analysis was performed to identify the risk factors predicting lymph node metastasis, and Fisher's exact test was used to confirm the lymph node spread mode according to the locations of primary tumors.Results: Totally, lymph node metastases presented in 131 patients (8.5%) in this series. Sixty-three patients presented N1 diseases, 17 patients showed only skipped N2 diseases, and 51 patients had simultaneous N1 and N2 positive lymph nodes. No lymph node metastasis was found in the patients with pure ground grass opacity (GGO). When patients were arbitrarily divided into six groups by the longest tumor diameter of