| Objective:A random sample of 179 patients with clinical stage I(T1c-2a)non-small cell lung cancer who underwent surgery at the Department of Thoracic Surgery I of the First Hospital of Jilin University from January 2019 to December 2021 was selected.The risk indicators associated with the development of lymph node metastasis of lung cancer in this group of patients were retrospectively analyzed as factors associated with the prediction.Methods:Retrospective study.One hundred and seventy-nine patients with non-small cell lung cancer who visited the Department of Thoracic Surgery I of the First Hospital of Jilin University from January 2019 to December 2021 were collected.All enrolled patients underwent preoperative chest CT examination at our hospital,and patients were clinically staged before surgery,and the staging range was selected for patients with T1c-2a N0M0.All patients underwent surgery,and postoperative lesions and cleared lymph node tissues had clear histopathological diagnostic results from our hospital.The enrolled patients were divided into a metastasis-positive experimental group and a metastasis-negative control group according to the reported results.The general clinical characteristics,clinical test indexes,imaging characteristics,pathological types and immunohistochemical typing of patients were determined as influencing factors,and the statistical analysis of different characteristic data was performed by the corresponding method through SPSS statistical software,and the difference was considered statistically significant at P < 0.05Results:A total of 179 patients with non-small cell lung cancer who underwent surgery were collected in this study,of whom 76(42.5%)were lymph node metastases and 103(57.5%)were lymph node-negative patients.Univariate analysis showed that the mean values of FEV1/FVC in the general clinical characteristics of the two groups were 74(66-81)in the lymph node-positive group;77(73-81)in the lymph nodenegative group,respectively,and the P value for the difference between the two groups was 0.020(P<0.05)by comparison.The rest of the indicators were not statistically different(P>0.05).In the analysis of the data from various tests,the lymph node positive group had a higher value of 21-1 in non-small cell lung cancer than the lymph node negative group,with a statistically significant difference(P <0.001).the D-dimer level was statistically different between the two groups(P = 0.04 < 0.05)and was higher in the lymph node positive group.The remaining routine blood indicators,systemic inflammatory response indicators(HRR,PLR,HALP,SII,NLR),NSE levels,CEA levels,albumin,alkaline phosphatase,and fibrinogen were not statistically significantly different(P > 0.05).In the analysis of imaging characteristics indicators,there were statistically significant differences in the maximum tumor CT diameter,determination of tumor as central or peripheral type according to CT images,whether it contained ground glass components,capillary collection sign,and vacuolar sign(P=0.002<0.05).The remaining factors such as whether they were multiple nodules,the presence of lobulated sign,and burr sign were not statistically significantly different(P > 0.05).In the analysis of pathological and immunohistochemical indexes,Ki-67 levels were statistically significantly different between the two groups(P< 0.001).The rest,such as pathology type,immunohistochemistry TTF-1,CK7,Napsin A,P40,CK56 were no no statistically significant differences(P > 0.05).Single regression analysis further verified that D-dimer,nonsmall cell lung cancer-associated antigen 21-1 level,CT tumor maximum diameter,tumor location(central/peripheral),presence of ground glass component,tumor capillary collection sign,vacuolar sign,and Ki-67 level were risk factors associated with positive lymph node metastasis of lung cancer.CT tumor maximum diameter and Ki-67 level were risk factors for lymph node metastasis and were continuous numerical variables,and the diagnostic effect analysis was performed,and the highest diagnostic effect was found for non-small cell lung cancer-associated antigen 21-1 level(AUC=0.691).Binary logistic multivariate regression analysis revealed that non-small cell lung cancer-associated antigen 21-1 level,tumor location(central/peripheral),presence of ground glass component,and capillary collection sign on tumor CT images were independent correlates of non-small cell lung cancer lymph node metastasis positive patients.Conclusions:(1)Non-small cell lung cancer-associated antigen 21-1 level,vascular set sign,central/peripheral type,and presence of ground glass component are independent risk factors for lymph node metastasis in clinical stage I(T1c-2a)non-small cell lung cancer;(2)The level of non-small cell lung cancer-associated antigen 21-1 is a good predictor of the presence of lymph node metastasis in clinical stage I(T1c-2a) non-small cell lung cancer. |
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