Analysis of clinicopathological factors and establishment of prediction model for lymph node metastasis in invasive lung adenocarcinoma
XIN Shaowei
WEN Miaomiao
WAN Zitong
YE Changqi
HAN Yong
XIONG Yanlu
Abstract：Objective To explore the correlation between lymph node metastasis and clinicopathological features of invasive lung adenocarcinoma,and establish a nomogram to predict the probability of lymph node metastasis of invasive lung adenocarcinoma.Methods The clinicopathological data of 1589 cases of primary invasive lung adenocarcinoma were retrospectively analyzed,including 737 males(46.4％)and 852 females(53.6％),with an median age of 61 years.The correlation of age,gender,smoking history,pathological subtypes,pathological components,tumor location,tumor diameter,visceral pleural invasion(VPI)and lymphovascular invasion(LVI)with lymph node metastasis was analyzed.The independent risk factors of lymph node metastasis were determined by univariate and multivariate Logistic regression and a nomogram model was established.The predictive efficiency and calibration degree of the model were evaluated by the receiver operating characteristic(ROC)and calibration curve.Results The total lymph node metastasis rate was 23.0％(366/1589).Patients with lymph node metastasis were younger and had larger tumor diameters compared to those without lymph node metastasis(P＜0.05).The proportion of males,VPI,LVI,and micropapillary/solid subtypes in the lymph node metastasis group was higher than that in the group without lymph node metastasis,and the difference was statistically significant(P＜0.05).Multivariate analysis showed that age＞60 years(OR=0.603,95％CI:0.459-0.793,P＜0.001)was an independent protective factor for lymph node metastasis,and tumor diameter(＞3 cm and ≤ 5 cm:OR=1.718,95％CI:1.263-2.336,P=0.001;＞5 cm:OR=2.332,95％CI:1.331-4.086,P=0.003),micropapillary/solid component(OR=3.978,95％CI:2.956-5.352,P＜0.001),VPI(OR=3.376,95％CI:2.410-4.728,P＜0.001)and LVI(OR=6.949,95％CI:4.162-11.602,P＜0.001)were independent risk factors for lymph node metastasis.ROC curve showed that the nomogram established based on the above clinicopathological features had a good predictive performance for lymph node metastasis(AUC=0.806,95％CI:0.779-0.833).Conclusion The nomogram based on clinicopathological features can better predict the risk of lymph node metastasis in invasive lung adenocarcinoma.
Keywords：Invasive lung adenocarcinomaLymph node metastasisPathological subtypeNomogram
Publication Date：2024-10-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 962-967 )