The Risk Factors For Spread Through Air Space Of Stage Ⅰ A Lung Adenocarcinoma Were Analyzed Based On The Propensity Score Matching Method

Objective: To study the risk factors of stage Ⅰ A lung adenocarcinoma spread through air space(STAS)based on propensity score matching method.Methods: Data of patients admitted to the Third Department of Thoracic Surgery,Shengjing Hospital Affiliated to China Medical University from September 2020 to August 2022 for lung surgery and reported as stage Ⅰ A lung adenocarcinoma were retrospectively collected and analyzed.Clinical data of the patients were collected,including weight,BMI,height,smoking history,gender,age,and Consolidation Tumor Ratio(CTR).Pathological data of the patients were collected,including major pathological subtypes of the tumor,tumor size,tumor stage,and tumor location.The data were divided into STAS positive group and STAS negative group according to the pathological reports.Propensity score matching method was used to remove confounding factors.Univariate analysis and binary Logistic regression analysis were used to study the risk factors for STAS in stage Ⅰ A lung adenocarcinoma.Results: A total of 362 cases were collected,including 41 cases in the STAS positive group and 321 cases in the STAS negative group.By using 1∶1 propensity score matching method,41 patients in each STAS positive group and STAS negative group were matched.Univariate analysis showed that smoking history,major pathological subtypes of Tumor,and CTR had statistical significance(all P<0.05),binary Logistic regression analysis showed that smoking history,CTR and papilla-dominated or micropapilla-dominated lung adenocarcinoma subtypes were independent risk factors for STAS(all P<0.05).Conclusions: For patients with stage Ⅰ A postoperative lung adenocarcinoma who had a history of smoking,whose CTR on CT images was greater than 48%,and whose postoperative pathological report was mainly papillary type or micropapillary type,clinicians need to be vigilant about the occurrence of STAS.