摘要
目的 分析老年肺癌患者临床病理特征、发生隐匿性淋巴结转移的影响因素.方法 回顾性选择自2022年1月至2024年1月榆林市中医医院收治的120例老年肺癌患者作为老年组,另选120例青年肺癌患者作为青年组.比较老年组与青年组的临床病理特征(性别、组织类型、分化程度、临床分期、基因突变、吸烟史、就诊原因、手术治愈).根据老年组患者是否发生隐匿性淋巴结转移,分为转移组(n=32)和非转移组(n=88),使用单因素及多因素Logistic回归分析老年肺癌患者发生隐匿性淋巴结转移的影响因素.根据肿瘤部位、肿瘤成分和毛刺征将老年肺癌患者分为高危组(n=38)和非高危组(n=82).分析不同危险因素分组的隐匿性淋巴结转移情况.结果 老年组与青年组在组织类型、分化程度、临床分期、基因突变、吸烟史、就诊原因和能否手术治疗上差异均有统计学意义(P＜0.05),其中老年组以鳞癌、分化程度为中高分化、临床分期为Ⅰ～Ⅱ期为主,吸烟史占比、手术治愈率均高于青年组,基因突变率、有症状就诊率均低于青年组,差异均有统计学意义(P＜0.05).经单因素及多因素Logistic回归分析,肿瘤部位、肿瘤成分、肿瘤毛刺征均是老年肺癌患者发生隐匿性淋巴结转移的独立影响因素(P＜0.05).高危组隐匿性淋巴结转移的发生率为68.42％,高于非高危组(7.32％),差异有统计意义(x2=25.871,P＜0.05).结论 老年肺癌患者以中高分化且Ⅰ-Ⅱ期的鳞癌为主,其中肿瘤部位、肿瘤成分和肿瘤毛刺征均是患者发生隐匿性淋巴结转移的独立影响因素,值得临床予以重视.
Abstract
Objective To analyze the clinical pathological characteristics and influencing factors of occulting lymph node metastases in elderly patients with lung cancer.Methods A total of 120 elderly patients with lung cancer admitted to Yulin Traditional Chinese Medicine Hos-pital from January 2022 to January 2024 were retrospectively selected as the elderly group,and 120 young patients with lung cancer were selected as the young group.The clinicopathological features(gender,histological type,degree of differentiation,clinical stage,gene mutation,smoking history,treatment reason,surgical cure)of the elderly group and the young group were compared.According to whether occult lymph node metas-tasis occurred in the elderly group,the patients were divided into the metastasis group(n=32)and the non-metastasis group(n=88).The influencing factors of occult lymph node metastasis in elderly patients with lung cancer were analyzed by univariate and multivariate logistic regres-sion analysis.The elderly patients with lung cancer were divided into the high-risk group(n=38)and the non-high-risk group(n=82)according to tumor location,tumor composition and burr sign.The occult lymph node metastasis of different risk factors was analyzed.Results There were statistically significant differences between the elderly group and the young group in tissue type,degree of differentiation,clinical stage,gene mutation,smoking history,reason for treatment and whether surgical treatment could be performed(P＜0.05).Among them,the elderly group was mainly squamous cell carcinoma,the degree of differentiation was moderately well differentiated,and the clinical stage was main-ly stage Ⅰ-Ⅱ,the proportion of smoking history and the cure rate of surgery were higher than those of the young group,and the gene mutation rate and symptomatic treatment rate were lower than those of the young group,the differences were statistically significant(P＜0.05).Univariate and multivariate logistic regression analysis showed that tumor location,tumor composition and tumor burr sign were independent influencing factors of occult lymph node metastasis in elderly patients with lung cancer(P＜0.05).The incidence of occult lymph node metastasis in the high-risk group was 68.42％,which was higher than that in the non-high-risk group(7.32％),the difference was statistically significant(x2=25.871,P＜0.05).Conclusion The young patients with lung cancer with low differentiation and Ⅲ-Ⅳ stage adenocarcinoma is given priority to,the composition of tumor site,tumor and tumor of burr indicators is independent of occult lymph node metastasis in patients with influence factors,worth clinical attach importance to it.
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