Motono Nozomu, Iwai Shun, Yamagata Aika, Iijima Yoshihito, Usuda Katsuo, Yamada Sohsuke, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
J Thorac Dis. 2021 Feb;13(2):824-830. doi: 10.21037/jtd-20-1722.
The risk factors for the development of chest wall invasion (CWI) in non-small cell lung cancer (NSCLC) patients are unclear. If the risk factors for the development of CWI can be clarified, surgical treatment might be able to be performed before CWI development, thus improving the prognosis.
In the present study, we enrolled patients who received surgery for NSCLC between January 2008 and December 2019 with available data on the maximum standardized uptake value (SUV) on positron emission tomography (PET) with lesions adjacent to the visceral pleura. Furthermore, the preoperative white blood cell (WBC) count, the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet (Plt) count, levels of lactate dehydrogenase (LDH) and C-reactive protein (CRP) were analyzed as predictive factors of CWI.
The relationships between CWI and clinicopathological variables were analyzed, and there were significant differences between patients with and without CWI in the age (P=0.02), maximum tumor diameter on computed tomography (CT) (P<0.01), diameter of tumors adjacent to the visceral pleura (P) (P<0.01), SUV (P<0.01), maximum tumor diameter on a pathological examination (P<0.01), WBC count (P=0.03), Plt count (P=0.04), and levels of LDH (P<0.01) and CRP (P=0.01). Logistic regression analyses of the risk factors related to CWI showed that the age (P=0.02), P (P=0.02), SUV (P=0.01), and LDH (P<0.01) were significant risk factors.
The age, P, SUV, and LDH levels might be associated with CWI.
非小细胞肺癌（NSCLC）患者发生胸壁侵犯（CWI）的危险因素尚不清楚。如果能够明确CWI发生的危险因素，或许可以在CWI发生前进行手术治疗，从而改善预后。
在本研究中，我们纳入了2008年1月至2019年12月期间接受NSCLC手术且有正电子发射断层扫描（PET）上与脏层胸膜相邻病变的最大标准化摄取值（SUV）可用数据的患者。此外，分析术前白细胞（WBC）计数、术前中性粒细胞与淋巴细胞比值（NLR）、血小板（Plt）计数、乳酸脱氢酶（LDH）水平和C反应蛋白（CRP）水平作为CWI的预测因素。
分析了CWI与临床病理变量之间的关系，有CWI和无CWI的患者在年龄（P=0.02）、计算机断层扫描（CT）上的最大肿瘤直径（P<0.01）、与脏层胸膜相邻的肿瘤直径（P）（P<0.01）、SUV（P<0.01）、病理检查的最大肿瘤直径（P<0.01）、WBC计数（P=0.03）、Plt计数（P=0.04）以及LDH水平（P<0.01）和CRP水平（P=0.01）方面存在显著差异。对与CWI相关的危险因素进行逻辑回归分析显示，年龄（P=0.02）、P（P=0.02）、SUV（P=0.01）和LDH（P<0.01）是显著的危险因素。
年龄、P、SUV和LDH水平可能与CWI有关。
