Retrospective Study Of Risk Factors For Lymph Node Metastasis In Lung Adenocarcinoma

Objective:To explore the influencing factors affecting lymph node metastasis of primary lung adenocarcinoma and establish a predictive model of lymph node metastasis.So as to predict the lymph node metastasis of patients accurately and to provide appropriate surgical plan and lymph node dissection plan and guide postoperative treatment.Methods:The clinical data of 312 patients with primary lung adenocarcinoma were retrospectively analyzed.All patients underwent lobectomy or sublobar resection(pulmonary or wedge resection),and all patients underwent systemic lymph node dissection or sampling for lymph node metastasis.Univariate and Logistic multivariate analysis factors of affecting lymph node metastasis.Results:There are 68 cases(21.8%)had lymph node metastasis in 312 patients.Univariate analysis showed that lymph node metastasis and pathological subtype of lung adenocarcinoma,pleural involvement,vascular involvement,nerve involvement,CEA level in tumor index and CA211 level,the proliferation index of Cell Ki67,CT value,tumor maximum diameter and other factors were statistically different,P<0.05;Logistics multivariate analysis showed vascularinvolvement (OR=11.969,95%CI=4.198-34.130,P<0.05)Preoperative tumor index CEA level (OR=1.105,95%CI=1.037-1.177,P<0.05),preoperative CT value(OR=1.008,95%CI=1.002-1.013,P<0.05),tumor maximum diameter(OR=1.418,95% CI=1.004-2.004,P<0.05)is an independent risk factor for lymph node metastasis in patients.The binary logistic regression coefficient and constant construction of lymph node metastasis prediction model.P=e~z/(1+e~z),Z=-20.119+2.482*Vascular invasion+0.1*CEA+0.008*CT value+0.350*Tumor diameter.Conclusion:The vascular involvement of patients with lung adenocarcinoma,preoperative tumor index CEA level,preoperative tumor CT value,and tumor maximum diameter are independent risk factors for lymph node metastasis.The lymph node metastasis prediction model can be used for lymph node metastasis.Therefore,it can play a good guidi the choice of surgical methods,the scope of lymph node dissection and postoperative treng role inatment.