摘要
目的:分析孤立性结节临床病理特征预测孤立性小肺癌的淋巴结转移不良因素。方法:选取天津市胸科医院2014年2-12月期间手术治疗结节<2cm的孤立性肺结节(SPN)患者100例,收集术前1周内的癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、术前CT和PET-CT资料,整理术后病理结果和淋巴结转移情况。在良恶性病例间分析患者临床资料,在恶性病例间分析影响淋巴结转移的因素,探讨影响淋巴结转移的独立因素。结果:在70例孤立性小肺癌和30例良性肺结节(肿瘤均≤2cm)的比较中,患者性别、年龄、吸烟史、结节部位、结节大小、血清Cyfra21-1在良恶性结节病理之间无统计学意义。而患者的血清CEA水平则有统计学意义(P=0.026),实性成分>50%是淋巴结转移的独立影响因素(OR=4.073,95%CI:18.161~25.19,P<0.05)。ROC曲线AUC=0.905。结论:SPN并非是肺癌的早期表现,有些患者已经存在了淋巴结转移,SPN实性成分>50%的患者存在淋巴结转移的高风险。
Objective:Compared the clinical and pathological data of the sample Identification and analysis of malignant and benign what influence of small lung cancer lymph node metastasis with clinical factors.Methods:From Tianjin chest hospital in February 2014 to December 2014 nodules after surgery<2cm of 100 patients with SPN,collected CEA,preoperative CT and PET-CT data,collection the pathological results and whether mediastinal lymph node metastasis after surgery.To compared the difference between malignant and benign cases and analysis of the influencing factors of mediastinal lymph node metastasis to explore which was independent factor of lymph node metastasis.Results:In 70 patients with small solitary lung cancer and 30 cases of benign pulmonary nodules(tumors were equal to or less than 2cm),the sex of the patient,and age,smoking history,nodule position,nodule size,serum CYFRA21-1between benign and malignant nodules pathologic no statistical significance.CEA level was statistically significant(P=0.026)between malignant and benign nodules.Solid component is greater than 50% are independent impact factors for lymph node metastasis(OR=4.073,95%CI:18.161~25.19,P<0.05).Conclusion:SPN is not early manifestation of lung cancer,some patients have existed for lymph node metastasis,solid component is greater than 50% of patients at high risk of lymph node metastasis.
出处
《医学理论与实践》
2015年第14期1821-1823,1827,共4页
The Journal of Medical Theory and Practice
