Correlation factors of N1 lymph node metastasis in patients with lung adenocarcinoma / 中华胸心血管外科杂志

ABSTRACT

Objective The mechanism of the lymph node metastasis in lung adenocarcinoma is unknown.The characteristic of the N1 and N2 lymph nodes metastasis are different.We explore the relationship between the N1 lymph node metastasis and clinicopathological factors in lung adenocarcinoma patients.Methods Data of 126 patients who had received lobectomy and systematic lymph node dissection were retrospectively analyzed.Chi-square test and Fisher exact method was used in univariate analysis,logistic regression was performed to analyze the multivariate analysis.Critical value was calculate in ROC.All the methods executed in software SPSS 19.0.Results After analyzed the N1 lymph node metastasis and clinicopathological factors,sex (P =0.016),diameter of tumor (P =0.001),pleural invasion (P =0.008),micropapillary pattern (P =0.028),solid pattern (P =0.047) has statistical significance in univariate analysis.Logistic regression analysis reveal diameter of tumor,micropapillary pattern and solid pattern were independent risk factors for N1 lymph nodes.CEA level (P =0.004),cancer embolus (P =0.029),micropapillary pattern (P =0.018),affect the groups (number of metastasis station) of the metastasis lymph nodes.Logistic regression analysis find CEA and micropapillary pattern were independent risk factors,which might lead multiple groups lymph nodes metastasis.There is only one factor could impact the location of the N1 lymph node metastasis,which is micropapillary pattern (P =0.027).Conclusion Via ROC results,there are three factors affect the N1 lymph nodes metastasispurity of micropapillary pattern more than 27.5％,purity of solid pattern more than 15％,diameter of tumor larger than 3.0 cm.If a lung adenocarcinoma patient who was in early stage has one or more than one factors,we suggest chemotherapy followed the surgery.Higher CEA level or higher content of micropapillary pattern much more groups lymph nodes metastasis might appear,so radiotherapy and other method should be considered to added on.High content of micropapillary pattern maybe imply cancer cell has already invaded extra pulmonary lymph nodes.