Clinicopathologic characteristics and prognostic study of lymph node metastasis of stage ⅠA-ⅢB lung invasive non-mucinous adenocarcinoma

Acta Universitatis Medicinalis Anhui 2025, 05, v.60 834-841     font:big middle small

Found programs: National Natural Science Foundation of China(No.82002449);Natural Science Foundation of Anhui Province of China(No.2008085QH350);Anhui Provincial Health and Medical Research Project(No.AHWJ2023A10143)

Authors:Ye Yuanzi; Zhang Siyuan;Xia Wanli ;Yang Ruxue; Xiao Han; Wang Wei

Keywords:lymph node metastasis;stage ⅠA-ⅢB invasive non-mucinous adenocarcinoma;clinicopathological features;genetic characteristics;prognosis;progression free survival

DOI:10.19405/j.cnki.issn1000-1492.2025.05.009

〔Abstract〕 Objective To explore the correlation between the clinical, pathological, genetic features, prognosis, and tumor lymph node metastasis in patients with stage ⅠA-Ⅲ B lung invasive non-mucinous adenocarcinoma(INMA). Methods A retrospective analysis was conducted on 67 eligible patients with INMA. Clinical data, histopathological assessments, and genetic testing were collected. Disease progression-free survival(PFS) was the primary endpoint through follow-up. The chi-square test or Fisher's exact test was used to analyse the correlation between tumour lymph node metastasis and clinicopathological and genetic characteristics. The Cox proportional hazards regression model and Kaplan-Meier method were used to analyse the impact of tumour lymph node metastasis on prognosis. Results A total of 67 patients were included, aged 46-77 years, with a median age of 61 years. Age, gender, and smoking history were not significantly associated with tumor lymph node metastasis. Larger tumor diameter, tumor progression, and receiving postoperative adjuvant treatment were associated with tumour lymph node metastasis(P<0.05). Poorer differentiated tumors according to International Association for the Study of Lung Cancer(IASLC) grading system was more likely to have lymph node metastasis(P=0.043). There was no significant difference in the types of driver gene mutations and lymph node metastasis. However,EGFRmutations were more common in patients without lymph node metastasis, while co-mutations were more common in patients with lymph node metastasis. Lymph node metastasis was significantly associated with PFS. Patients without lymph node metastasis had a significantly better PFS compared to those with lymph node metastasis(P=0.002). Under different treatment conditions, patients without lymph node metastasis exhibited a significant advantage in PFS when untreated. While treatment showed a trend toward improved PFS, the difference did not reach statistical significance. Additionally, no significant differences in PFS were observed between patients with or without lymph node metastasis following chemotherapy or targeted therapy. Conclusion Lymph node metastasis in INMA patients is related to tumor size, progression status, and gene co-mutations, and is a key prognostic indicator affecting PFS.