临床外科杂志 ›› 2023, Vol. 31 ›› Issue (7): 622-625.doi: 10.3969/j.issn.1005-6483.2023.07.007

• 论著 • 上一篇    下一篇

吸烟对临床ⅠA期肺腺癌病人淋巴结转移和预后的影响:单中心研究结果

  

  1. 200052  上海交通大学附属松江医院(筹)胸外科(薛家龙);北部战区总医院胸外科(刘星池、金希冬、鞠玲玲、张才燚、张怡宁、刘博)
  • 收稿日期:2022-10-18 接受日期:2022-10-18 出版日期:2023-07-20 发布日期:2023-07-20
  • 通讯作者: 刘博,Email:liubo_thoracics@163.com

Effect of smoking on lymph node metastasis and prognosis in patients with clinical stage ⅠA lung adenocarcinoma:a single institutional experience

  1. Department of Thoracic Surgery,Songjiang Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200052,China
  • Received:2022-10-18 Accepted:2022-10-18 Online:2023-07-20 Published:2023-07-20

摘要: 目的   通过比较不同吸烟状态病人的淋巴结转移情况,探讨吸烟对临床ⅠA期腺癌病人淋巴结转移的影响。  方法  2013年12月~2017年12月间在我院行解剖性肺叶切除术的临床ⅠA期(cⅠA期)肺腺癌病人156例,其中曾经吸烟病人47例(FSG组)、吸烟病人45例(SG组),从不吸烟病人64例(NSG组)。对三组病人围术期指标、肿瘤直径、分化程度、淋巴结转移和预后资料进行比较。  结果   SG、FSG和NSG组病人的淋巴结转移率中位数分别为24.49%、22.77%和10.19%,肿瘤最大直径分别为2.54cm、2.62cm和2.36cm,其中,SG组和FSG组病人的淋巴结转移率高于NSG组病人(P<0.05)。Logistic回归分析发现,吸烟情况、分化程度是病人淋巴结转移的独立影响因素。术后生存方面,有吸烟史(SG组和FSG组)病人发生淋巴结转移的风险更大,吸烟史和分化程度是病人预后的独立影响因素(CI值分别为1.297~6.829和1.054~1.280)。  结论   有吸烟史的病人发生淋巴结转移的风险大于从不吸烟病人,吸烟和分化程度是病人淋巴结转移的独立影响因素。

关键词: 吸烟, 淋巴结转移, 临床ⅠA期, 肺腺癌

Abstract: Objective   By comparing the lymph node metastasis of patients with different smoking status,the aim of current research was to investigate the effect of smoking on the LN metastasis rate of clinical stage ⅠA adenocarcinoma patients.  Methods   A total of 156 patients with clinical stage ⅠA lung adenocarcinoma were collected with different smoking stage from December 2013 to December 2017.All patients were grouped into three groups according to current smoking stage as former smoking group (FSG,n=47),smoking group (SG,n=45),and never smoking group (NSG,n=64).And compare the perioperative indexes,tumor size,degree of differentiation and lymph node metastasis rate,as well as prognosis data of different group patients.  Results   The median lymph node metastasis rates in SG, FSG and NSG groups were 24.49%, 22.77% and 10.19%, respectively.The maximum tumor diameters were 2.54cm, 2.62cm and 2.36cm, respectively.The rate of lymph node metastasis in SG and FSG group was higher than that in NSG group(P<0.05).Logistic regression analysis showed that smoking status and differentiation degree were independent influencing factors of lymph node metastasis.In terms of postoperative survival, patients with a history of smoking (SG and FSG) had a greater risk of lymph node metastasis, and smoking history and differentiation were independent prognostic factors(CI:1.297-6.829 and 1.054-1.280,respectively).Conclusion   Patients with a history of smoking have at greater risk of lymph node metastasis than those who never smoking,and smoking and the degree of differentiation are independent influencing factors of lymph node metastasis in patients.

Key words: somking, lymph node metastasis, clinical stage ⅠA, adenocarcinoma

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