Ⅰ期肺腺癌伴脉管癌栓相关因素分析

Analysis of related factors of stage I lung adenocarcinoma with lymphovascular invasion

目的分析Ⅰ期肺腺癌伴脉管癌栓发生的相关因素。方法回顾性分析2016年1月—2018年5月于天津市胸科医院胸外科行手术治疗、且术后病理确诊为Ⅰ期肺腺癌的229例患者的临床病理资料。患者按照是否伴有脉管癌栓分为脉管癌栓组和非脉管癌栓组。分析发生脉管癌栓的影响因素。结果单因素分析显示,Ⅰ期肺腺癌伴脉管癌栓发生与肿瘤直径、附壁成分、腺泡成分、乳头成分、微乳头成分、伴有脏层胸膜侵犯、术前中性粒细胞/淋巴细胞(NLR)、术前癌胚抗原(CEA)有关(P<0.05)。多因素分析结果显示,肿瘤直径≥2.2 cm、微乳头成分≥12.8%、脏层胸膜侵犯为脉管癌栓发生的独立危险因素。结论临床中应重视肿瘤直径、微乳头成分、脏层胸膜侵犯等影响脉管癌栓发生的危险因素,对伴脉管癌栓的患者尽早进行针对性的治疗,使患者生存期延长。

Objective To investigate the related factors of stageⅠpulmonary adenocarcinoma with lymphovascular invasion.Methods Clinical data of 229 patients with stageⅠlung adenocarcinoma treated by surgical treatment and pathologically diagnosed as stageⅠlung adenocarcinoma in Tianjin Chest Hospital from January 2016 to May 2018 were retrospectively analyzed.The patients were divided into two groups:lymphovascular invasion group and non-lymphovascular invasion group,and the influencing factors of lymphovascular invasion for lung adenocarcinoma in stageⅠwere analyzed.Results The univariate factor analysis showed that pulmonary adenocarcinoma in stageⅠwith lymphovascular invasion was related to diameter of tumor,lepidic pattern,acinar pattern,papillary pattern,micropapillary pattern,pleural invasion,preoperative neutrophil-lymphocyte ratio(NLR)and preoperative carcinoembryonic antigen(CEA,P<0.05).Multivariate Logistic regression analysis showed that diameter of tumor≥2.2 cm,micropapillary pattern≥12.8%and pleural invasion were the risk factors for lymphovascular invasion.Conclusion Attention should be paid to the risk factors of lymphovascular invasion in clinic,such as tumor diameter,micropapillary pattern and visceral pleural invasion.And the patients with lymphovascular invasion should be treated as early as possible so as to prolong their survival time.