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| STAS阳性可手术切除NSCLC患者的临床特征 |
| Clinical characteristics of surgically resectable non-small cell lung cancer patients with positive spread through air spaces |
| 投稿时间：2025-08-19 |
| DOI：10.3969/j.issn.1000-0399.2026.07.016 |
| 中文关键词: 气道播散 肺癌,非小细胞 临床特征 |
| 英文关键词: Spread through air spaces Lung cancer,non-small cell Clinical characteristics |
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| 中文摘要: |
| 目的 分析气道播散（STAS）阳性可手术切除非小细胞肺癌（NSCLC）患者的临床特征，为制定个体化手术方案提供参考。方法 回顾性收集2021年1月至2023年12月于安庆市立医院行根治性手术的584例可手术切除NSCLC患者的临床、影像、病理及肿瘤标志物资料。采用单因素分析比较STAS阳性组与阴性组间各变量的差异，将单因素分析存在差异有统计学意义的变量纳入多因素二元logistic回归模型，筛选STAS阳性的独立危险因素。结果 符合纳入标准的可手术切除NSCLC患者共有584例，其中259例病理结果提示STAS阳性。单因素分析提示STAS阳性与阴性患者在性别、吸烟史、病理最长直径、病理T分期、胸膜侵犯、脉管侵犯、影像学密度特征、分叶征、毛刺征、空泡征、手术方式、癌胚抗原（CEA）的差异有统计学意义。多因素分析示吸烟（OR=2.033,95%CI:1.165～3.547,P=0.012）、胸膜侵犯（OR=4.411,95%CI:1.604～12.134,P=0.004）、脉管侵犯（OR=4.986,95%CI:2.392～10.393,P<0.001）、实性病灶（OR=12.542,95%CI:3.941～39.914,P<0.001）、亚实性病灶（OR=3.689,95%CI:1.236～11.011,P=0.019）、空泡征（OR=1.819,95%CI:1.040～3.179,P=0.036）、异常CEA水平（OR=2.375,95%CI:1.080～5.224,P=0.032）是STAS阳性表达的独立危险因素。结论 可手术切除NSCLC患者中，吸烟史、胸膜侵犯、脉管侵犯、影像学表现为实性或亚实性病灶、伴有空泡征、CEA水平升高为STAS阳性的独立危险因素。 |
| 英文摘要: |
| Objective To analyze the clinical characteristics of patients with operable non-small cell lung cancer positive for spread through air spaces to provide reference for developing individualized surgical strategies. Methods A retrospective collection was conducted on the clinical, imaging, pathological, and tumor marker data of 584 patients with operable NSCLC who underwent radical surgery at Anqing Municipal Hospital from January 2021 to December 2023. Univariate analysis was used to compare the differences of each variable between the STAS-positive and STAS-negative groups, and all variables with P<0.05 in the univariate analysis were incorporated into a multivariate binary logistic regression model to screen for independent risk factors for STAS positivity. Results A total of 584 patients with operable NSCLC meeting the inclusion criteria were enrolled, among whom 259 had pathological results indicating STAS positivity. Univariate analysis showed statistically significant differences between the two groups in sex, smoking history, pathological maximum diameter, pathological T stage, pleural invasion, vascular invasion, imaging density features, lobulation sign, spiculation sign, vacuole sign, surgical approach, and carcinoembryonic antigen(CEA). Multivariate analysis showed that smoking(OR=2.033, 95%CI: 1.165～3.547, P=0.012), pleural invasion(OR=4.411,95%CI: 1.604～12.134,P=0.004), vascular invasion(OR=4.986,95%CI: 2.392～10.393,P<0.001), solid lesions(OR=12.542,95%CI: 3.941～39.914,P<0.001), subsolid lesions(OR=3.689,95%CI:1.236～11.011,P=0.019), vacuole sign(OR=1.819,95%CI:1.040～3.179,P=0.036), and abnormal carcinoembryonic antigen level(OR=2.375,95%CI:1.080～5.224,P=0.032) were independent risk factors for positive STAS expression. Conclusion In patients with operable NSCLC, smoking history, pleural invasion, vascular invasion, imaging presentation as solid or subsolid lesions, presence of vacuole sign, and elevated CEA level are independent risk factors for positive STAS. |
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