Analysis Of Risk Factors For Postoperative Recurrence Of Stage Ⅰ Invasive Lung Adenocarcinoma

Objective: Surgical resection is the main treatment for stage I invasive lung adenocarcinoma,and the prognosis of postoperative patients is significantly different.In 2011,the new classification criteria of lung adenocarcinoma jointly put forward by International Association for the Study of Lung Cancer,American Thoracic Society and European Respiratory Society can effectively predict the prognosis of patients according to pathological subtypes.This paper mainly studies the stage I invasive lung adenocarcinoma after surgical resection,analyzes the influence of various clinicopathological features on the survival and prognosis of patients,and looks for the risk factors affecting tumor recurrence.Methodes: The clinicopathological data of patients with stage I invasive lung adenocarcinoma who underwent surgical resection in thoracic surgery in our hospital from January 2014 to December 2016 were analyzed retrospectively.The factors analyzed retrospectively included sex,age,smoking history,tumor size,tumor stage,pleural invasion,mode of operation,postoperative chemotherapy and pathological subtypes.Among them,the pathological subtypes were divided into two groups:(1)according to the highest proportion of pathological subtypes,it was divided into six main pathological subtypes: lepidic predominant,acinar predominant,papillary predominant,micropapillary predominant,solid predominant,adenocarcinoma infiltrative type and so on.(2)according to the presence or absence of certain pathological subtypes,they can be divided into:lepidic components,acinar components,papillary components,micropapillary components,solid components and so on.Statistical methods: Univariate and multivariate analysis of Cox regression analysis in SPSS 25.0 were used to analyze the above-mentioned related factors.Kaplan-Meier was used to analyze survival and compare the differences among survival factors.Results: Of the 309 patients with stage I invasive lung adenocarcinoma after operation,23 had recurrence and metastasis.Cox univariate analysis showed that the influencing factors of DFS and OS were operation mode,micropapillary component and lepidic component,while pleural invasion,pathological subtype and papillary component only affected DFS.Cox multivariate analysis showed that the influencing factors of DFS and OS were mode of operation and micropapillary components,while pleural invasion and solid predominant adenocarcinoma only affected DFS.Kaplan-Meier survival analysis showed that micropapillary component and lepidic component were the influencing factors of DFS and OS,while pleural invasion,mode of operation,pathological subtype and papillary component only affected DFS.Conclusion: Pleural invasion,mode of operation,solid predominant adenocarcinoma and micropapillary component are independent risk factors that significantly affect the recurrence,metastasis and survival prognosis of patients with stage I invasive lung adenocarcinoma.For these patients,it is necessary to take closer follow-up and more active adjuvant therapy to improve the postoperative efficacy and prognosis.