Analysis Of Risk Factors Of Dry Pleural Dissemination For Non-small Cell Lung Cancer

ObjectivesTo investigate the risk factors of dry pleural dissemination(DPD)for non-small cell lung cancer and to provide reference for clinical decision-making.MethodsNinety-one patients who underwent surgery from January 2013 to January 2020 and were confirmed to have DPD of non-small cell lung cancer were collected as the DPD group,and one hundred and eight patients who underwent surgery in the same period and were confirmed to been non-small cell lung cancer without pleural dissemination were randomly selected as the non-DPD group.The relevant clinical and imaging data were compared to find the risk factors for DPD of non-small cell lung cancer.The threshold was got from ROC curve and Youden index.ResultsResults of univariate analysis showed that chest or back pain symptom(P<0.01),the imaging signs such as pleural nodules(P<0.01),pleural thickening(P<0.01),pleural indentation(P=0.024),nodal enlargement(P=0.007),tumor size(P<0.01)and preoperative carcinoma embryonic antigen(CEA)value(P =0.004)were associated with DPD.Logistic regression analysis showed that chest or back pain symptom(P<0.01),pleural nodules(P<0.01)and Tumor size(P<0.01)were independent risk factors for DPD.The threshold of tumor size was 2.75 cm.In the comparison of coagulation function between the two groups,the fibrinogen(P=0.002)and the D-dimer(P<0.001)level was significantly increased in DPD group.But there was no statistical differences between two groups in PT,APTT,and TT(P>0.05).ConclusionFor patients with primary non-small cell lung cancer,the incidence of DPD is significantly higher when the patient complain about chest or back pain,has the imaging signs such as pleural nodules and Tumor size greater than 2.75 cm.In contrast to patients with non-small cell lung cancer without pleural metastases,the blood of patients with DPD is in a hypercoagulable status.