基于倾向性评分匹配探讨病灶密度在肺腺癌淋巴结转移中的价值

Investigating the Value of Lesion Density in Lymph Node Metastasis of Lung Adenocarcinoma Based on Propensity Score Matching

目的:使用倾向性评分匹配(PSM)探讨病灶密度在肺腺癌淋巴结转移中的价值。方法:回顾性分析246例肺腺癌患者(淋巴结转移51例,非淋巴结节转移195例)的基本临床资料及CT图像特征,采用单因素及多因素分析PSM匹配前后实性及部分实性在肺腺癌淋巴结转移中的价值。结果:淋巴结转移组密度为实性、部分实性及纯磨玻璃者分别有42例、7例和2例,非淋巴结转移组则分别有58例、69例和68例。单因素分析结果表明病灶密度、直径及支气管截断在2组间差异均有统计学意义(P<0.05)。二元logistic回归分析结果表明病灶密度及直径为肺腺癌淋巴结转移的独立危险因素。经过PSM分析1︰1匹配48对患者中,淋巴结转移组密度为实性、部分实性及纯磨玻璃者分别有40例、6例和2例,非淋巴结转移组则分别有13例、13例和22例。单因素分析显示病灶密度在2组间差异仍有统计学意义(P<0.05),而其余因素在2组间差异均无统计学意义(P>0.05)。结论:使用PSM在均衡变量、减少偏倚后表明,实性及部分实性肺腺癌患者淋巴结转移风险较高,而纯磨玻璃较少发生淋巴结转移。

Purpose:To investigate the value of lesion density in lymph node metastasis of lung adenocarcinoma using propensity score matching(PSM).Methods:The basic clinical data and CT image characteristics of 164 patients with lung adenocarcinoma were retrospectively analyzed,including 51 cases with lymph node metastasis and 195 cases with non-lymphoid nodule metastasis.The value of solid and partial solid in lymph node metastasis of lung adenocarcinoma before and after PSM was analyzed by univariate and multivariate analysis.Results:Number of solid,partial solid and pure ground glass density in lymph node metastasis group were 42 cases,7 cases and 2 cases and 58 cases,69 cases and 68 cases in non-lymph node metastasis group respectively.Univariate analysis showed that lesion density,diameter,and bronchial truncation were with statistical significance between the two groups(P<0.05).Binary logistic regression analysis showed that lesion density and diameter were independent risk factors for lymph node metastasis of lung adenocarcinoma.There were 48 pairs patients after 1︰1 matching by PSM.Solid,partial solid and pure ground glass density in lymph node metastasis group were 40 cases,6 cases and 2 cases,and 13 cases,13 cases and 22 cases in non-lymph node metastasis group respectively.Univariate analysis showed that the density of lesions remained with statistical significance between the two groups(P<0.05),while other factors were with no statistical significance(P>0.05).Conclusion:After balancing variables and reducing bias by PSM,it showed that lung adenocarcinoma patients with solid and partially solid are more prone to with lymph node metastasis,while pure ground glass is less likely to with lymph node metastasis.