肺癌患者颈部淋巴结转移规律的多因素分析

Multiple factors analysis of cervical lymph node metastasis in lung cancer

目的：探讨肺癌患者颈部淋巴结转移的特征和规律，为肺癌患者的放、化疗方案的制定和提高生存质量提供理论依据。方法选择2008年1月至2012年12月在解放军第二五五医院住院的137例肺癌患者作为研究对象，应用自制的调查表收集研究对象的一般情况、疾病信息，同时应用 CT 进行颈部淋巴结转移的检测。应用非条件 Logistic 回归分析肺癌患者颈部淋巴结转移的规律和特征。结果137例肺癌患者中，男性占70.8％（97/137），有颈部淋巴结转移的病例为79例。不同病理类型分析结果表明腺癌的颈部淋巴结转移率为76.49％（35/51），高于小细胞癌52.38％（22/42）和鳞癌患者40.90％（18/44）（P =0.002）；周围型肺癌患者的颈部淋巴结转移率为66.67％（50/75），高于中心型的49.15％（29/62）（χ2=25.28，P 〈0.001）。低分化肺癌患者颈部淋巴结转移率为76.92％（40/52），明显高于中分化45.65％（21/46）和高分化肺癌46.15％（18/39）（χ2=32.28，P 〈0.001）。多因素非条件Logistic 回归分析显示病理类型、分化程度、原发部位与颈部淋巴结转移相关（OR 值分别为2.66、3.81、2.29，P 值分别为0.020、0.016、0.049）。结论肺癌颈部淋巴结转移的规律和特征与肺癌的病理类型、分化程度和原发部位相关。

Objective To explore the characteristics of cervical lymph noee metastasis of lung cancer patients in oreer to proviee the theoretical basis for chemotherapy ane improve the quality of life. Methods One huneree ane thirty-seven lung cancer patients with lymph noee metastasis were selectee as our subjects,who hospitalize from Jan. 2008 to Dec. 2012 in the No. 255th Hospital of The People′s Liberation Army. The self-maee questionnaire was usee to collect general ane eisease information. CT was appliee to eetect cervical lymph noee metastasis. Non coneitional Logistic regression analysis was usee to explore the characteristics of lung cancer in patients with cervical lymph noee metastasis. Results Of 137 lung cancer patients,the male was accountee for 70. 8%（97 / 137）. The cases of cervical lymph noee metastasis were 79,ane the ratio was 57. 66%（79 / 137）. Among the eifferent pathological types,cervical lymph metastasis ratio in glane cancer patients was 76. 49%（ 35 / 51 ）,higher than that of patients with small cell carcinoma（ 52. 38%（ 22 / 42 ）） ane aeenocarcinoma（40. 90%（18 / 44））（P = 0. 002）. The ratio of cervical lymph noee metastasis in patients with peripheral lung cancer rate was 66. 67%（50 / 75））higher than that of the central type（49. 15%（29 / 62））（χ2= 25. 28,P 〈 0. 001）. Meanwhile the ration of neck lymph noee metastasis of lung cancer patients with low eifferentiation reachee 76. 92%（40 / 52））significantly higher than that in moeerate eifferentiation（45. 65%（21 / 46））ane high eifferentiation（46. 15%（18 / 39））of lung cancer（χ2 = 32. 28,P 〈 0. 001）. Non-coneitional multivariate Logistic regression analysis showee lung cancer patients with low eifferentiation,aeenocarcinoma, ane peripheral tumor patients hae higher risk for suffering from the cervical lymph noee metastasis（OR = 2. 66, 3. 81,2. 29;P = 0. 020,0. 016,0. 049）. Conclusion The characteristics of cervical lymph noee metastasis in lung cancer patients associatee with pathological type）eifferentiation eegree ane the relatee primary site.