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目的探讨周围性肺腺癌支气管内侵犯的相关因素。方法收集临床确诊的周围型肺癌患者101例,术前完善胸部CT、支气管镜检查,统计分析年龄、性别、肿瘤直径、表皮生长因子受体(EGFR)基因突变、胸膜侵犯、淋巴结转移与支气管侵犯的关系。结果男性患者50例,女性患者51例。术后病理TNM分期Ⅰ期患者51例,Ⅱ期患者24例,ⅢA期患者26例。EGFR基因突变患者65例,野生型患者36例。支气管内侵犯患者33例,淋巴结侵犯患者37例,胸膜侵犯患者70例。支气管内侵犯组肿瘤直径(47.3±24)mm,支气管内未侵犯组肿瘤直径(29.9±20.4)mm,支气管内侵犯组年龄(65.7±9.71)岁,支气管内未侵犯组年龄(59.1±8.60)岁。多因素分析显示EGFR基因突变、淋巴结侵犯、肿瘤直径、年龄对支气管内侵犯有显著影响(P<0.05),性别、胸膜是否侵犯对支气管内侵犯无明显影响(P>0.05)。结论周围性肺腺癌支气管内侵犯与年龄、淋巴结侵犯、EGFR基因突变、肿瘤直径有明显的相关性。
Objective To investigate the related factors of bronchial invasion in peripheral lung adenocarcinoma. Methods A total of 101 patients with clinically diagnosed peripheral lung cancer were collected. Thorax CT and bronchoscopy were performed before surgery. The age, sex, tumor diameter, EGFR gene mutation, pleural invasion, lymph node metastasis and bronchial invasion were statistically analyzed Relationship. Results 50 male patients and 51 female patients. Postoperative pathological TNM stage 51 cases of stage Ⅰ patients, 24 cases of stage Ⅱ, 26 cases of stage Ⅲ A patients. 65 cases of EGFR gene mutation and 36 cases of wild type. Bronchial invasion of patients in 33 cases, lymph node invasion in 37 cases, 70 cases of pleural invasion. The mean tumor size was (47.3 ± 24) mm in the group of intrabronchial invasion, 29.9 ± 20.4 mm in the noninvasive group, and 65.7 ± 9.71 in the group of intrabronchial invaders (59.1 ± 8.60) year old. Multivariate analysis showed that mutations of EGFR gene, lymph node invasion, tumor diameter and age had significant effects on the invasion of bronchus (P <0.05). There was no significant difference between gender and pleural invasion on intrabronchial invasion (P> 0.05). Conclusion The bronchial invasion of peripheral lung adenocarcinoma is related to age, lymph node invasion, EGFR gene mutation and tumor diameter.