Study Of Risk Factors Of Lymph Node Metastasis In Lung Adenocarcinoma With Diameter ? 3 Cm

Objective:This study aims to identify the risk factors of lymph node metastasis in patients with lung adenocarcinoma that diameter is less than 3 cm,so as to decide the extent of lymph node dissection reasonably in patients with early stage lung cancer.Methods: We retrospectively reviewed the patients who were diagnosed as lung adenocarcinoma and received anatomical lobectomy/segmentectomy plus systemic lymph node dissection in our department from September 2016 to November 2018.The connection between Sex,Age,Tumor location,Tumor type,Tumor diameter,Preoperative lymph node status,Serum CEA level,Pathological type,Pathological subtype,Visceral pleural involvement,Vascular involvement,Bronchial wall immersion and Lymph node metastasis were analysed respectively by SPSS 22.0.Results:320 patients were enrolled in this study,the total number of lymph nodes dissected were 4519,with an average of 14.1 lymph nodes per patient.There were 28(8.8%)cases had lymph node metastasis in total.No lymph nodes involvement were found in pGGO or AIS/MIA groups.Multivariate logistic regression analysis showed that pure solid nodules,lymph node with a short axis diameter > 1 cm,visceral pleural involvement and vascular involvement were independent risk factors for lymph node metastasis.If all four factors were absent,none of 190 patients had lymph node metastasis.Conclusions:(1)Systematic lymph node dissection should be performed in patients with pure solid nodules,lymph nodes with a short axis diameter > 1 cm,visceral pleural involvement and vascular involvement.(2)Selective lymph node dissection or lymph node sampling are feasible procedure in patients without risk factors for lymph node metastasis.(3)Patients with pGGO,AAH,AIS or MIA are Unnecessary to received lymphadenectomy.