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河北医学  2017, Vol. 23 Issue (11): 1805-1809    DOI: 10.3969/j.issn.1006-6233.2017.11.013
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280例cT1aN0M0肺腺癌淋巴结转移影响因素的回顾性分析
张书勤, 魏柏, 丰小敏, 夏佩, 马薇
华中科技大学同济医学院附属梨园医院肿瘤科, 湖北 武汉 430077
Retrospective Analysis of Influencing Factors of Lymph Node Metastasis in 280 Cases of cT1aN0M0 Lung Adenocarcinoma
ZHANG Shuqin, WEI Bai, FENG Xiaomin, et al
Liyuan Affiliated Hospital of Tongji Medical University, Hubei Wuhan 430077, China
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摘要 目的: 探究影响cT1aN0M0肺腺癌淋巴结转移的影响因素。方法: 选取我院2013年1月至2015年12月收治的280例cT1aN0M0肺腺癌患者的临床病例资料,对其淋巴结转移情况以及患者的临床因素进行回顾性统计分析。对患者的病理特征以及相关临床资料,联合单一因素和多种因素共同分析,探究cT1aN0M0肺腺癌淋巴结转移的影响因素。结果: 经过对所有入选的280例cT1aN0M0肺腺癌患者进行薄层CT扫描之后发现,CT影像学类型为纯磨玻璃影的患者108例(38.6%),CT影像学类型为磨玻璃影带有实性成分的患者(实性成分直径<5mm)117例(41.8%),CT影像学类型为部分实性结节的患者(实性成分直径≥5mm)12例(4.3%),CT影像学类型为纯实性结节的患者43例(15.4%)。患有淋巴结转移的患者28例(10%),其中N1淋巴结转移患者16例(5.7%)N2淋巴结转移患者12例(4.3%)。本次研究对象中,所有实性成分直径小于5mm及CT影像学类型为纯磨玻璃影的患者在经过手术治疗之后均未发现淋巴结转移,P<0.05。结论: 临床上cT1aN0M0肺腺癌患者,若其影像学表现为纯磨玻璃影或实性成分直径小于5mm,通常没有淋巴结转移情况发生。患者肿瘤直径大于1cm,混合性结节和实性结节以及CEA>5μg/L等成为淋巴结转移的重要预测因素。PET-CT表明,当最大标准摄入值大于5时,患者更容易发生淋巴结转移,P<0.05。
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关键词 肺腺癌淋巴结淋巴结转移临床预测因素临床分期    
AbstractObjective: To explore the risk factors of lymph node metastasis in cT1aN0M0 lung adenocarcinoma. Methods: The clinical data of 280 cases of cT1aN0M0 lung adenocarcinoma patients admitted between January 2013 and December 2015 in our hospital were selected, and the lymph node metastasis and clinical factors were retrospectively analyzed. The pathological characteristics and clinical data of the patients, single factor and multiple factors analysis were done to explore the influence factors of lymph node metastasis of cT1aN0M0 lung adenocarcinoma. Results: After all the 280 patients with cT1aN0M0 lung adenocarcinoma underwent thin slice CT scan, 108 patients (38.6%) were found to have pure glass opacity in CT imaging. Ground glass opacity combined with solid components (<5mm) were found in 117 cases (41.8%). Ground glass opacity combined with solid nodules (solid component diameter <5mm) were found in 12 cases (4.3%), pure solid nodules (solid component diameter ≥5mm) were found in 43 cases (15.4%). Patients with lymph node metastasis were 28 (10%), of which 16 patients (5.7%) with N1 lymph node metastasis and 12 patients (4.3%) with N2 lymph node metastasis. In this study, all of the patients with a diameter of less than 5 mm in diameter or with pure ground glass opacity, no lymph node metastasis after surgery were found, P<0.05, the difference was significant. Conclusion: For cT1aN0M0 lung adenocarcinoma patients, if the imaging performance were pure grinding glass or solid components of the diameter is less than 5 mm, there is usually no lymph node metastasis occurred. In patients with tumor diameter greater than 1cm, mixed nodules and solid nodules and μg/L CEA>5 were important prognostic factors for lymph node metastasis. Analysis of the maximum standard uptake value in patients with PET-CT showed that patients were more likely to have lymph node metastasis when the maximum standard uptake value was greater than 5(P<0.05).
Key wordsLung cancer    Lymph node    Lymph node metastasis    Clinical predictors    Clinical stage
    
通讯作者: 马薇   
引用本文:   
张书勤, 魏柏, 丰小敏, 夏佩, 马薇. 280例cT1aN0M0肺腺癌淋巴结转移影响因素的回顾性分析[J]. 河北医学, 2017, 23(11): 1805-1809.
ZHANG Shuqin, WEI Bai, FENG Xiaomin, et al. Retrospective Analysis of Influencing Factors of Lymph Node Metastasis in 280 Cases of cT1aN0M0 Lung Adenocarcinoma. HeBei Med, 2017, 23(11): 1805-1809.
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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2017.11.013     或     http://www.hbyxzzs.cn/CN/Y2017/V23/I11/1805
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