| ⅠA~ⅢA期磨玻璃为主型肺癌发生高危浸润的相关因素分析 |
| 投稿时间：2025-08-05 修订日期：2025-08-15 点此下载全文 |
| 引用本文：苏雷,高艳,魏兵,张毅,王腾腾,李元博,钱坤,王雷明,魏秀芹.ⅠA~ⅢA期磨玻璃为主型肺癌发生高危浸润的相关因素分析[J].医学研究杂志,2025,54(12):44-52, 59 |
| DOI：
10.11969/j.issn.1673-548X.2025.12.009 |
| 摘要点击次数: 25 |
| 全文下载次数: 17 |
|
| 基金项目:国家重点基础研究发展计划项目(2011CB510100) |
|
| 中文摘要:目的 探讨磨玻璃为主型肺癌(ground glass-dominant lung cancer, GDLC)发生高危浸润的形式及影响因素,为临床医师预判磨玻璃影(ground glass opacity, GGO)的浸润风险和选择术式提供参考依据。方法 回顾性分析2020年1月～2024年1月于首都医科大学宣武医院胸外科接受单孔胸腔镜手术治疗的1126例ⅠA~ⅢA期GDLC患者的临床资料,包括个人史、影像学资料和术后病理,探讨这些指标与发生气腔播散(spread through air spaces, STAS)、脉管浸润(lymphatic invasion, LYI)、脏层胸膜侵犯(visceral pleural invasion, VPI)高危浸润的相关性。结果 1126例GDLC患者中,男性407例(36.1%),女性719例(63.9%),平均年龄为62.09±9.45岁。GGO影像学最大径度均值为19.73±8.80mm。肺叶切除462例(41.0%),肺段切除417例(37.1%),楔形切除247例(21.9%)。术后病理分期中,ⅠA期1045例,ⅠB期49例,ⅡA期10例,ⅡB期9例,ⅢA期13例。发生高危浸润269例(23.9%),包括240例(21.3%)单一高危浸润(single high-risk infiltration, SRI)和29例(2.6%)复合高危浸润(composite high-risk infiltration, CRI)。多因素Logistic回归分析结果显示,患者恶性肿瘤病史(OR=5.447,P＜0.05)、GGO径度(OR=1.588,P＜0.01)、胸膜征(OR=4.980,P＜0.001)、空泡征(OR=1.846,P＜0.05)、GGO类型(OR=3.328,P＜0.001)、CTR特征(OR=1.746,＜0.01)是影响GDLC发生高危浸润的独立影响因素。结论 ⅠA~ⅢA期GDLC发生的高危浸润及其形式与病理分期呈线性相关,对患者恶性肿瘤病史、GGO径度、胸膜征、空泡征、GGO类型和CTR特征的综合评估,有助于胸外科医生对GGO的浸润风险做出较为准确的预判,以针对性地选择肺叶或亚肺叶切除。 |
| 中文关键词:磨玻璃为主型肺癌 高危浸润 影响因素 |
| |
| Analysis of Relevant Factors for High-risk Infiltration in Stage ⅠA-ⅢA Ground-glass-dominant Lung Cancer. |
|
|
| Abstract:Objective To explore the occurrence patterns and influencing factors of high-risk infiltration in ground glass-dominant lung cancer (GDLC), providing a reference basis for clinicians to predict the infiltration risk of ground glass opacity (GGO) and select surgical procedures. Methods A retrospective analysis was conducted on the clinical data of 1126 patients with stage ⅠA-ⅢA GDLC who underwent single-port thoracoscopic surgery in the Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University from January 2020 to January 2024, including personal history, imaging data, and postoperative pathology. The correlation between these indicators and the occurrence of high-risk infiltrations such as spread through air spaces (STAS), lymphatic invasion (LYI), and visceral pleural invasion (VPI) was investigated. Results Among 1126 patients with GDLC, 407 cases (36.1%) were male, and 719 cases (63.9%) were female, with an average age of 62.09±9.45 years. The average maximum diameter of GGO imaging was 19.73±8.80mm. 462 cases (41.0%) underwent lobectomy, 417 cases (37.1%) underwent segmentectomy, and 247 cases (21.9%) underwent wedge resection. Among the postoperative pathological stages, there were 1045 cases in stage ⅠA, 49 cases in stage ⅠB, 10 cases in stage ⅡA, 9 cases in stage ⅡB, and 13 cases in stage ⅢA. 269 cases (23.9%) had high-risk infiltration, including 240 cases (21.3%) with single high-risk infiltration (SRI), and 29 cases (2.6%) with composite high-risk infiltration (CRI). The results of multivariate Logistic regression analysis showed that the patient′s history of malignant tumors (OR=5.447, P＜0.05), GGO diameter (OR=1.588, P＜0.01), pleura traction sign (OR=4.980, P<0.001), vacuolar sign (OR=1.846, P＜0.05), GGO type (OR=3.328, P<0.001), and CTR characteristics (OR=1.746, P＜0.01) were the independent influencing factors on the occurrence of high-risk infiltration in GDLC. Conclusion The high-risk infiltration and its form of stage IA-IIIA GDLC are linearly correlated with pathological stage. A comprehensive analysis of the patient′s history of malignant tumors, GGO diameter, pleural sign, vacuolar sign, GGO type, and CTR characteristics can help thoracic surgeons make more accurate predictions about the risk of GGO infiltration, and make appropriate choices for lobectomy or sub-lobectomy. |
| keywords:Ground-glass-dominant lung cancer High-risk infiltration Influence factor |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
