The Risk Factor Analysis For Lymph Node Metastasis In Clinical Stage Ia Lung Adenocarcinoma

Background and purpose: Lymph node metastasis is the main way of lung adenocarcinoma spread to, also is the important factor influencing the prognosis.At present, the risk of lymph node metastasis in clinical stage Ia lung adenocarcinoma is unknown, for such patients should do systemic lymph node dissection or sampling is uncertain.The purpose of this study is to investigate the risk factors for lymph node metastasis in clinical stage Ia lung adenocarcinoma, so as to provide reference for clinical decision making.Methods: The clinical pathologic data of 230 consecutive patients with clinical stage Ia lung adenocarcinoma who underwent surgical resection in our hospital from January 2012 to September 2014 were retrospectively reviewed. Using SPSS software to perform a statistical analysis,and refreshing the related literatures at the same time to evaluate the risk factors of lymphatic metastasis. Results: A total of 32 cases with lymph node metastasis in the all 230 cases of stage c Ia lung adenocarcinoma,.The transfer rate was 13.9%,the p N1 9 cases,23 cases of p N2.Single factor analysis showed that the pathological subtype, the maximum diameter of pulmonary nodule,the serum CEA level were the the related risk factors for lymph node metastasis.65 cases of non invasive lung adenocarcinoma were no lymph node metastasis,and all subtypes of invasive lung adenocarcinoma and invasive mucinous adenocarcinoma had Varying degrees of lymph node metastasis.10 mm or less, 11 mm ~ 20 mm, 21 mm ~ 30 mm three groups,the lymph node metastasis rate was 1.6%, 16.5% and 23.9% respectively, the difference of the transfer rate was significant(P = 0.002).Serum CEA level in 5 ng/ml or less and > 5 ng/ml group of lymph node metastasis rate was 10.1%, 38.7%, the difference also statistically significant(P = 0.000).Logistic regression analysis results suggested that serum CEA levels and pulmonary nodules maximum diameter was associated with a significant presence of lymph node metastasis, the OR value were 3.351 and 1.101;but pathological subtype, in this study seemed no predictive value for the existence of lymph node metastasis. Conclusions: Even in patients with the stage c Ia lung adenocarcinoma, there is still a certain proportion of lymph node metastasis.Pathological subtype,pulmonary nodules maximum diameter and serum CEA level are the important risk factors for lymph node metastasis in clinical stage Ia lung adenocarcinoma.For the patients with invasive pulmonary adenocarcinoma or invasive mucinous adenocarcinoma, pulmonary nodules maximum diameter > 10 mm,elevated serum CEA levels, the lymph node should be regular dissected;Suggest that the lymph node of non invasive lung adenocarcinoma can be omitted base on this study.