临床I期肺癌隐匿淋巴结转移模式及术前危险因素分析

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-02-27 DOI:10.1016/j.lungcan.2025.108461

Young Ho Yang, Ha Eun Kim, Byung Jo Park, Jin Gu Lee, Dae Joon Kim, Chang Young Lee

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引用次数: 0

摘要

目的探讨I期肺癌隐匿淋巴结转移（OLNM）的特点及术前危险因素。方法回顾性研究临床I期肺癌行系统性淋巴结清扫术的患者。分析按叶（上/下）排列的OLNM频率及术前OLNM的危险因素。结果共纳入1512例患者（分别为892例和620例上、下叶癌）。OLNM和跳跃转移率分别为11.2%和1.9%。对于N1淋巴结，无论肿瘤位置如何，最常见的转移部位是大叶淋巴结（7.6%），其次是叶间淋巴结（2.9%）和肺门淋巴结（1.9%）。对于N2淋巴结，上叶癌倾向于转移到上纵隔（4.2% vs. 1.4%，下纵隔），而下叶癌转移到下纵隔（5.0% vs. 0.5%，上纵隔）。吸烟（危害比[HR]: 1.722, 95%可信区间[CI]: 1.206 ~ 2.460）、非外周部位（HR: 2.374, 95% CI: 1.663 ~ 3.389）、最大肿瘤大小>；2 cm (HR: 2.335, 95% CI: 1.488-3.663)，实变/肿瘤（C/T）比>；0.75 （HR: 16.958, 95% CI: 7.839 ~ 36.687）和胸膜邻近（HR: 1.696, 95% CI: 1.177 ~ 2.444）增加了OLNM的风险。结论I期肺癌最常见的转移部位为大叶淋巴结，与肿瘤位置无关。因此，在进行节段切除术时，切除大叶淋巴结对于术中评估淋巴结转移非常重要。C/T比率>；0.75为OLNM术前最强危险因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Patterns and preoperative risk factors of occult lymph node metastasis in clinical stage I lung cancer

查看原文本刊更多论文

Patterns and preoperative risk factors of occult lymph node metastasis in clinical stage I lung cancer

Objectives

To investigate the patterns and preoperative risk factors of occult lymph node metastasis (OLNM) in patients with stage I lung cancer.

Methods

This retrospective study evaluated patients with clinical stage I lung cancer who underwent systematic lymph node dissection. OLNM frequency by lobe (upper/lower) and preoperative risk factors of OLNM were analyzed.

Results

Overall, 1512 patients (892 and 620 patients with upper and lower lobe cancers, respectively) were included. The rates of OLNM and skip metastasis were 11.2 % and 1.9 %, respectively. For N1 lymph nodes, the most common site of metastasis was the lobar lymph nodes (7.6 %), regardless of the cancer location, followed by the interlobar (2.9 %) and hilar (1.9 %) lymph nodes. For N2 lymph nodes, upper lobe cancers tended to metastasize to the superior mediastinum (4.2 % vs. 1.4 %, inferior mediastinum), while lower lobe cancers metastasized to the inferior mediastinum (5.0 % vs. 0.5 %, superior mediastinum). Smoking (hazard ration [HR]: 1.722, 95 % confidence interval [CI]: 1.206–2.460), non-peripheral location (HR: 2.374, 95 % CI: 1.663–3.389), maximal tumor size > 2 cm (HR: 2.335, 95 % CI: 1.488–3.663), consolidation/tumor (C/T) ratio > 0.75 (HR: 16.958, 95 % CI: 7.839–36.687), and pleural abutting (HR: 1.696, 95 % CI: 1.177–2.444) increased the risk of OLNM.

Conclusion

In stage I lung cancer, the most common site of metastasis is the lobar lymph nodes, regardless of tumor location. Therefore, when segmentectomy is performed, dissection of the lobar lymph node dissection is important for the intraoperative evaluation of lymph node metastasis. A C/T ratio > 0.75 is the strongest preoperative risk factor of OLNM.

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.