Analysis Of Risk Factors Of Spread Through Air Spaces In Stage IA Lung Adenocarcinoma

Objective To investigate the risk factors of spread through air spaces(STAS)in stage IA lung adenocarcinoma.Methods The clinical data of patients with stage IA lung adenocarcinoma who underwent lung surgery in The First Affiliated Hospital of Xinjiang Medical University from Nov.2020 to Dec.2021 were retrospectively collected.According to the pathological results,the patients were divided into STAS positive group and STAS negative group.Univariate analysis and binary Logistic regression analysis were used to analyze the risk factors of STAS in stage IA lung adenocarcinoma between the two groups.Results A total of 254 patients with lung adenocarcinoma were included,whose mean age was(58.02±10.11).Univariate outcome analysis showed that STAS positive group patients had larger tumor size(19.47±4.65 mm vs 16.64±6.21 mm,t=-2.620,P<0.05),higher consolidation tumor ratio(CTR)(0.66 vs0.27,Z=-6.692,P<0.01)compared with STAS negative group patients.There were significant differences between the two groups in terms of lobulation sign(χ~2=22.899),vacuole sign(χ~2=5.798),pleural retraction(χ~2=5.670),vascular convergence sign(χ~2=23.534),pathological low differentiation(χ~2=20.601),micropapilla(χ~2=70.179),papilla(χ~2=17.875),solidsubtype adenocarcinoma(χ~2=10.378),carcinoembryonic antigen(CEA)positive(χ~2=20.601),anaplastic lym-phoma kinase(ALK)fusion(χ~2=6.009)and ros proto-oncogene 1,receptor tyrosine kinase(ROS1)fusion(χ~2=49.953)(P<0.05).Multivariate analysis showed that there were stastically differences in CTR[odds ratio(OR)=20.582,P<0.05],vascular convergence sign(OR=29.464,P<0.01),micropapillary adenocarcinoma(OR=41.432,P<0.01),ROS1 fusion(OR=524.075,P<0.01),ALK fusion(OR=143.104,P<0.01)and CEA positive(OR=15.154,P<0.05)between the two groups.Conclusion CTR,vascular cluster sign,micropapillary adenocarcinoma,ROS1 fusion,ALK fusion and CEA positive are independent risk factors of STAS in stage IA lung adenocarcinoma.When CTR>0.49,clinicians should be alert to the occurrence of STAS.