453例非小细胞肺癌患者隆突下淋巴结转移因素分析

Risk factors of subcarinal lymph node metastasis in 453 patients with Non-small cell lung cancer

目的 分析非小细胞肺癌(NSCLC)患者隆突下淋巴结转移情况及影响其转移的高危因素,为NSCLC是否行隆突下淋巴结清扫提供建议及参考。方法 回顾性分析2020-01—2022-11安阳市肿瘤医院胸外科行肺癌根治术并隆突下淋巴结清扫术的453例NSCLC患者的临床资料,采用Logistic回归模型进行多因素分析,确定隆突下淋巴结转移的危险因素。结果 453例NSCLC患者中,23例(5.1%)患者发生隆突下淋巴结转移。单因素分析显示,病变大小、病理类型、分化程度、胸膜侵犯、脉管癌栓为NSCLC隆突下淋巴结转移的危险因素(P<0.05)。Logistic回归分析显示,分化程度、胸膜侵犯、脉管癌栓为NSCLC隆突下淋巴结转移的独立危险因素(P<0.05)。结论 NSCLC发生隆突下淋巴结转移的总体概率不高,分化程度、胸膜侵犯、脉管癌栓是决定其是否发生隆突下淋巴结转移的独立危险因素。

Objective To analyze the subcarinal lymph node metastasis and risk factors of non-small cell lung cancer(NSCLC),and to provide suggestions and reference for the subcarinal lymph node dissection of NSCLC.Methods The clinical data of 453 patients with NSCLC who underwent Lobectomy and systematic lymph node dissection in Anyang Tumor Hospital from 2020-01 to 2022-11 were retrospectively collected.The risk factors for subcarinal lymph node metastasis of non-small cell lung cancer were analyzed.Results Totally 23 of the 453 patients had the subcarinal lymph node metastasis,and the metastasis rate was 5.1%.Univariate analysis showed that lesion size,pathological type,degree of differentiation,pleural invasion and vascular tumor thrombus were risk factors for the subcarinal lymph node metastasis of NSCLC(P<0.05).Further Logistic regression analysis showed that the degree of differentiation,pleural invasion and vascular tumor thrombus were independent risk factors for the subcarinal lymph node metastasis of NSCLC(P<0.05).Conclusion The overall probability of the subcarinal lymph node metastasis in NSCLC is not high,and the degree of differentiation,pleural invasion and vascular tumor thrombus are independent risk factors for the subcarinal lymph node metastasis.