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1.连云港市第一人民医院胸外科,江苏 连云港 222000
2.南京医科大学第四附属医院胸外科,江苏 南京 210031
收稿:2025-03-03,
纸质出版:2026-01-25
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孙海军,胡硕,陈光辉等.肺癌患者肺切除术后复发的相关因素研究[J].局解手术学杂志,2026,35(01):32-35.
SUN Hai-jun,HU Shuo,CHEN Guang-hui,et al.Risk factors for recurrence after segmentectomy in patients with lung cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):32-35.
孙海军,胡硕,陈光辉等.肺癌患者肺切除术后复发的相关因素研究[J].局解手术学杂志,2026,35(01):32-35. DOI: 10.11659/jjssx.03E025013.
SUN Hai-jun,HU Shuo,CHEN Guang-hui,et al.Risk factors for recurrence after segmentectomy in patients with lung cancer[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):32-35. DOI: 10.11659/jjssx.03E025013.
目的
2
探讨肺癌患者肺切除术后复发的相关因素。
方法
2
回顾性分析2020年1月至2022年2月于连云港市第一人民医院行动脉流域解剖性部分肺切除术或肺段切除术的147例肺癌患者的临床资料,根据术后是否复发分为复发组(
n
=13)和非复发组(
n
=134)。比较患者一般资料及实验室指标。采用
Logistic
回归模型分析患者术后复发的相关危险因素;采用受试者工作特征(
ROC
)曲线评估危险因素对复发的预测价值。
结果
2
单因素分析显示,肿瘤最大直径、TNM分期、分化程度、纵隔淋巴结转移及血管内皮生长因子(VEGF)、癌胚抗原(CEA)、可溶性CD105(sCD105)水平与肺癌患者术后复发有关(
P
<
0.05);多因素分析结果显示,肿瘤最大直径
>
3 cm(
OR
=63.603)、TNM分期Ⅱ~Ⅲ期(
OR
=47.135)、低分化(
OR
=1 734.720)、纵隔淋巴结转移(
OR
=95.248)、VEGF
>
9 ng/mL(
OR
=294.260)、CEA
>
5 ng/mL(
OR
=86.280)、sCD105
>
4 ng/mL(
OR
=34.187)是肺癌患者术后复发的独立危险因素(
P
<
0.05)。
ROC
曲线分析结果显示,上述危险因素联合对肺癌患者术后复发具有较高的预测价值[曲线下面积(
AUC
)=0.976,95%
CI
:0.948~1.000,敏感度为0.923,特异度为0.963
]
。
结论
2
肿瘤最大直径较大、TNM分期较高、低分化、纵隔淋巴结转移及CEA、VEGF、sCD105水平较高是肺癌患者术后复发的独立危险因素,在临床评估肺癌患者术后复发方面具有重要参考价值。
Objective
2
To identify risk factors for recurrence after segmentectomy in patients with lung cancer.
Methods
2
A retrospective analysis was conducted on the clinical data of 147 lung cancer patients who underwent anatomical partial lobectomy guided by arterial watershed analysis or segmentectomy at Lianyungang First People's Hospital from January 2020 to February 2022. Patients were categorized into the recurrence group (
n
=13) and the non-recurrence group (
n
=134) based on whether postoperative recurrence occurred. The general data and laboratory parameters of patients were compared.
Logistic
regression model was employed to identify the related risk factors for postoperative recurrence,and the predictive value of risk factors for recurrence was assessed using
receiver operating characteristic
(
ROC
) curve.
Results
2
Univariate analysis showed that tumor maximum diameter, TNM staging, degree of differentiation, mediastinal lymph node metastasis, and levels of vascular endothelial growth factor (VEGF), carcinoembryonic antigen (CEA), and soluble CD105 (sCD105) were associated with postoperative recurrence in patients with lung cancer (
P
<
0.05). Multivariate analysis revealed that tumor maximum diameter
>
3 cm (
OR
=63.603), TNM stage of Ⅱ to Ⅲ (
OR
=47.135),poor differentiation (
OR
=1 734.720),mediastinal lymph node metastasis (
OR
=95.248),VEGF
>
9 ng/mL (
OR
=294.260), CEA
>
5 ng/mL (
OR
=86.280) and sCD105
>
4 ng/mL (
OR
=34.187) were the independent risk factors for postoperative recurrence in patients with lung cancer (
P
<
0.05). The
ROC
curve showed that the combination of the above risk factors demonstrated excellent predictive performance for
postoperative recurrence in patients with lung cancer [
area under the curve
(
AUC
)=0.976,95%
CI
: 0.948~1.000, with sensitivity of 0.923 and specificity of 0.963].
Conclusion
2
A larger tumour maximum diameter,advanced TNM stage, poor differentiation, mediastinal lymph node metastasis,and elevated levels of CEA, VEGF and sCD105 are the independent risk factors for postoperative recurrence in lung cancer patients. These factors hold significant value for the clinical assessment of postoperative recurrence in patients with lung cancer.
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