Altern Ther Health Med. 2023 May;29(4):188-193.
Early detection of pulmonary nodules in lung cancer and timely intervention can improve the number of diagnoses at early stages of lung cancer and can reduce mortality. At present, it's not possible to accurately determine the degree of pathological invasion of ground-glass nodules and the probability of regional lymph node metastasis using an imaging examination before surgery.
The study intended to analyze the clinical, imaging, and pathological characteristics of malignant pulmonary nodules and to explore the high-risk factors for lymph node metastasis, using logistic regression multivariate analysis.
The research team retrospectively analyzed lung-cancer patients' demographic and clinical data.
The study took place in the Department of Thoracic Surgery at Zhangzhou Municipal Hospital, affiliated with Fujian Medical University, in Zhangzhou, China.
Participants were 1168 patients with malignant pulmonary nodules at the hospital between January 2018 and December 2020.
The research team: (1) collected participant's pulmonary nodules after surgical resection, which the hospital had confirmed were primary lung cancer and (2) analyzed the clinical characteristics of the malignant pulmonary nodules using the World Health Organization's (WHO's) 2021 classification standard for lung-cancer tissue. The research team also collected participants' data, including gender, age, smoking status, nodular size, imaging characteristics, pathological type, degree of invasion, and lymph node metastasis, and analyzed the clinical characteristics of the malignant pulmonary nodules and explored the risk factors for lymph node metastasis.
Participants' average age was 56.79 ± 11.53 years, and the study included 675 females (57.79%) and 493 males (42.21%), 932 of whom didn't smoke (79.8%). Imaging indicated that most participants had nodules in the upper lobes of the lungs, 424 participants in the right lung (36.30%) and 303 in the left (25.94%). Imaging also showed that 400 participants had pure ground-glass nodules (34.25%) and 371 had solid nodules(31.76%), 355 had partial solid nodules (30.39%), the other 42 had cavitary nodules (3.60%) , and 1098 participants had adenocarcinoma (94.00%). Regarding the incidence of lymph node metastasis, 67 participants had N1 metastasis (5.74%) and 34 had N2 metastasis (2.91%). The multivariate logistic regression analysis showed that an increase in the nodular size (P < .001); the presence of lower-lobe pulmonary nodules, the nodular site (P = .025); and the amount of solid components in the nodule, the nodule's features (P < .001), were significant adverse factors for N1 lymph node metastasis, while gender, age, and smoking status didn't affect that outcome.
Adenocarcinoma was the most common pathological type, and the probability of lymph node metastasis was low. N1 lymph node metastasis was associated with increased nodular size and solid components and the presence of lower lobe nodules.
肺癌中肺结节的早期发现和及时干预可以提高肺癌早期诊断的数量，并降低死亡率。目前，在手术前的影像学检查中，无法准确确定磨玻璃结节的病理侵袭程度和区域淋巴结转移的概率。
本研究旨在通过逻辑回归多因素分析，分析恶性肺结节的临床、影像学和病理特征，并探讨淋巴结转移的高危因素。
研究团队回顾性分析了肺癌患者的人口统计学和临床数据。
本研究在福建医科大学附属漳州市医院胸外科进行。
参与者为 2018 年 1 月至 2020 年 12 月期间在该医院经手术切除后被确认为原发性肺癌的 1168 例恶性肺结节患者。
（1）研究团队收集了参与者手术后的肺结节，这些结节已经被医院确认为原发性肺癌；（2）使用世界卫生组织（WHO）2021 年肺癌组织分类标准分析恶性肺结节的临床特征。研究团队还收集了参与者的数据，包括性别、年龄、吸烟状况、结节大小、影像学特征、病理类型、侵袭程度和淋巴结转移情况，并分析了恶性肺结节的临床特征，探讨了淋巴结转移的危险因素。
参与者的平均年龄为 56.79±11.53 岁，研究包括 675 名女性（57.79%）和 493 名男性（42.21%），其中 932 名不吸烟（79.8%）。影像学检查显示，大多数参与者的结节位于肺上叶，其中 424 名在右肺（36.30%），303 名在左肺（25.94%）。影像学还显示，400 名参与者有纯磨玻璃结节（34.25%），371 名有实性结节（31.76%），355 名有部分实性结节（30.39%），其他 42 名有空腔结节（3.60%），1098 名参与者有腺癌（94.00%）。关于淋巴结转移的发生率，67 名参与者有 N1 转移（5.74%），34 名有 N2 转移（2.91%）。多因素逻辑回归分析显示，结节大小增大（P<0.001）；下叶肺结节（P=0.025）；以及结节内实性成分的数量，结节的特征（P<0.001）是 N1 淋巴结转移的显著不利因素，而性别、年龄和吸烟状况对该结果无影响。
腺癌是最常见的病理类型，淋巴结转移的概率较低。N1 淋巴结转移与结节大小和实性成分的增加以及下叶结节的存在有关。
