The Correlation Of Lymph Node Metastasis With Clinical Feature And Gene Mutation In PT1 Lung Adenocarcinoma

ObjectiveThe incidence and mortality of lung cancer has become the first malignant tumor.In recent years,with the advancement of technical means,the diagnosis rate of early lung cancer is getting higher and higher,and the clinical risk factors for lymph node metastasis of pathological T1 lung gland.There are few studies on the association between the two.This study,through retrospective analysis of clinical data,aims to discover the risk clinical features of lymph nodes in pT1 adenocarcinoma and the difference of gene mutation rate between lymph node metastasis group and non-metastasis group.Methods344 patients with T1 stage lung adenocarcinoma who underwent surgical treatment from the First Affiliated Hospital of Zhengzhou University from December 2016 to June 2018 were enrolled.The postoperative pathological data and medical record information were recorded in detail.Lymph node metastasis and non-metastasis groups.One hundred and forty-five of the 344 patients underwent postoperative genetic testing and were divided into EGFR mutation and non-mutation groups.Data were analyzed by SPSS for single factor and multivariate statistical analysis.Studies were performed on gender,age,smoking history,tumor size,degree of differentiation,carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),and cytokeratin 19(CYFRA21-1),tumor location,and the difference of gene mutation rate between Lymph node metastasis and non-metastasis group.ResultsOf the 344 patients with pT1 lung adenocarcinoma,67 patients in the metastatic group had a shift rate of 19.2%,which was related to gender(p=0.011),tumor size(p=0.041),and degree of differentiation(p=0.001).The rate was 6.10%,and there was no significant correlation with clinical parameters(p>0.05);145 patients with pT1 lung adenocarcinoma,EGFR mutant 109,mutation rate accounted for 75.17%,There was a statistically significant difference in the rate of EGFR mutation between lymph node non-jump metastasis and skip metastasis(p=0.039),and the non-jump group mutation rate was higher than that of the skip group.It can be considered that non-jump metastasis patients are more prone to EGFR mutation.Conclusion1.In pT1 lung adenocarcinoma,the female,the diameter of the tumor >2cm,and the poor differentiation of the tumor are independent risk factor for lymph node metastasis;2.In pT1 lung adenocarcinoma,Non-skip N2 metastasis patients are more prone to EGFR mutations.