非小细胞肺癌N2淋巴结转移的危险因素分析

目的研究多种影响因素与NSCLCN2淋巴结转移之间的关系。方法回顾性分析接受18F．FDGPET／CT检查和手术治疗的NSCLC患者，将其分为无N2淋巴结转移（非N2＋）和有N：淋巴结转移（N2＋）2组，采用x2检验或两样本t检验比较2组问性别、年龄、肿瘤部位、肿瘤大小、SUVmax、病理学类型及分化程度等影响因素的差异，然后将组间有统计学意义的影响因素及分组进行量化赋值，先后用单因素回归和多因素logistic回归分析确定对N：淋巴结转移有意义的危险因素。结果共纳入177例患者，其中男109例，女68例，年龄（60．1±10．6）岁。非N2＋（142例）和N；（35例）2组间的肿瘤大小（36．1±19．7）mm和（49．3±24．4）mm]、SUV-（8．81±6．23和11．21±4．43）和分化程度（高分化：3和0例；中分化：74和11例；低分化：65和24例）差异均有统计学意义（t=-2．969和-2．633，疋。6．143，均P〈0．05），而性别、年龄、肿瘤部位和组织学类型差异均无统计学意义（X2=0．374—4．999，t=0．836，均P〉0．05）。单因素分析显示，肿瘤大小、sUVmax及分化程度与N2淋巴结转移相关（r=0．201、0．245和0．185，均P〈0．05）；而多因素分析示，只有SUVmax与N2淋巴结转移之间的相关性具有统计学意义（P=0．546，P〈0．01）。NSCLCN：淋巴结的转移概率随着原发病灶SUVmax的增加而增加；当原发灶SUVmax≤2．5时，发生N：淋巴结转移的概率为0，而SUVmax〉7．5时概率为O．29。结论SUVmax是NSCLC发生N2淋巴结转移的危险因素。

Risk factors for N2 lymphatic metastasis in patients with non-small cell lung cancer

Objective To assess risk factors in NSCLC with N2 metastasis. Methods A total of 177 NSCLC patients （109 males, 68 females; age： （60.1± 10.6） years） who underwent both lSF-FDG PET/CT scan and surgery were enrolled. They were divided into two groups. One was with N2 metastasis （N2） and the other was without （non-N2）. The gender, age, location, size, primary tumor SUVmax, his-topathologic type and differentiation grade between N2 group and non-N2 group were compared with X2 test and two-sample t test. After assignment of significant factors and groups, correlations between each factor and group were analyzed with uni- and multivariate analyses, and then the risk factors were identified finally with logistic regression analysis. Results Significant difference among factors of tmnor size （（36.1±19.7） mm vs （49.3±24.4） mm）, SUVmax（8.81±6.23 vs 11.21±4.43） and differentiation grades （high： 3 vs 0; moder ate： 74 vs 11; poor： 65 vs 24） were observed between non-N2 group and N： group （t =-2.969, -2.633, X2= 6.143, all P〈0. 05）. Besides, the univariate analysis showed significant correlations between tumor size, SUVmax, differentiation grade and N2 status （r=0.201, 0.245, 0.185, all P〈0.05）. However, multivariate logistic regression revealed that only SUVmax had a predictive value （fl=0.546, P〈0.01）. The incidence of N2 metastasis went up along with the increase of SUVm=. There was no N2 metastasis in the patients with SUVmax〈2.5, and the incidence rate of metastasis increased to 0.29 in those with SUVmax〉7.5. Conclusion SUVmax may be an independent risk factor to predict N2 metastasis in NSCLC patients.