Clinicopathologic Features And Risk Factors Of Lymph Node Metastasis In Patients Undergoing Surgery For Non-small Cell Lung Cancer

Objective(s):The objective of this study was to describe the clinicopathologic features of patients undergoing surgery for non-small cell lung cancer in Yunnan Cancer Hospital from 2013 to 2022.To explore the risk factors affecting lymph node metastasis.Methods:1.Retrospective collection from January 1,2013 to January 1 General clinicopathological data(gender,age,height,weight,smoking history,family history,tumor size,tumor location,tumor markers,pathological types,surgical conditions,number of lymph node dissection stations,and clinical data of 7288 patients with non-small cell lung cancer who underwent the first operation for lung cancer +systematic lymph node dissection in The Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital)on December 31,2022.The number of swept pieces,the number of transfer stations,the number of transferred pieces,etc.)to describe the clinicopathological characteristics of these patients.2.The study subjects were divided into lymph node metastasis group and non-metastatic group according to whether lymph node metastasis was present.t test and Chi-square test were used to compare the differences in clinical and pathological data between the two groups,and variables with differences were incorporated into the binary logistic regression model to analyze the risk factors affecting lymph node metastasis of lung cancer.Results:1.A total of 7288 patients were included in our hospital during 2013-2022.The majority of patients were in the upper lobe of right lung(2178 cases,accounting for29.88%).The left superior lobe of the lung was followed by 1720 patients,accounting for 23.60%.Lobectomy was performed in 6617 patients(90.79%)and thoracoscopic surgery was performed in 5314 patients(72.91%).5785 cases were adenocarcinoma,accounting for 79.38%;1265 cases of squamous cell carcinoma,accounting for 17.36%;There were 123 cases in stage 0,accounting for 1.69%;Stage I 4354 cases(59.74%);Stage II 1207 cases(16.56%);Stage III-IV 1604 cases(22.01%);4791 patients with tumor diameter ≤3cm,accounting for 65.74%;There were1750 patients > 3cm,≤5cm,accounting for 24.01%;There were 541 patients > 5cm,≤7cm,accounting for 7.42%;There were 206 patients with > 7cm,accounting for2.83%.Among 7288 patients undergoing surgery for non-small cell lung cancer,a total of 1704(23.38%)patients had lymph node metastasis.Among 1704 patients with lymph node metastasis,there were 583(34.21%)patients with pure N1 metastasis and1121(65.79%)patients with N2 metastasis.In N2 lymph node metastasis stations,tumors in the right upper lobe of lung were more likely to metastasize to group 4(33.20%),tumors in the right middle lobe of lung were more likely to metastasize to group 7(39.09%),tumors in the right lower lobe of lung(50.50%)and left lower lobe of lung(42.94%)were more likely to metastasize to group 7(37.32%),and tumors in the left upper lobe of lung were more likely to metastasize to group 5(37.32%).2.According to whether lymph node metastasis occurred,the patients were divided into lymph node metastasis group and lymph node non-metastasis group,and the Body Mass Index(BMI)difference between the two groups was not statistically significant.There was no significant difference in lymph node metastasis rate between different age groups(23.11%vs23.88%)and between groups with or without previous family history of tumor(23.18%vs23.38%)(P > 0.05).There were significant differences in lymph node metastasis rates among different groups based on gender,smoking status,tumor location and tumor size,whether CEA,CYFRA21-1 and SCC-Ag were elevated or not,and the differences were statistically significant(P <0.05).In multivariate Logistic regression analysis,gender,tumor size,CEA,CYFRA21-1 and pathological type were independent risk factors for lymph node metastasis of non-small cell lung cancer(P < 0.05).Conclusion(s):1.Tumors in the upper lobes of both lungs are more common in patients undergoing 10-year surgery for non-small cell lung cancer in our center;Adenocarcinoma is the main pathological type.The majority of surgical patients were in the early stage.Thoracoscopic lobectomy is the main surgical procedure.2.Mediastinal lymph node metastasis has certain lobular specificity.3.Male patients with tumor diameter > 3cm,elevated CEA,abnormal CYFRA21-1,and squamous cell carcinoma as pathological type may be independent risk factors for lymph node metastasis.