T1期肺腺癌同步脑转移危险因素分析

郭杨; 杜春仙; 龙云; 甘甜; 李婷; 张可萌; 廖美焱

doi:10.14188/j.1671-8852.2024.0756

您当前的位置：

首页 >

文章列表页 >

T1期肺腺癌同步脑转移危险因素分析

肿瘤学研究 | 更新时间：2026-11-05

- T1期肺腺癌同步脑转移危险因素分析
- Analysis of risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma
- 武汉大学学报（医学版） 2025年46卷第11期页码：1436-1440
- 作者机构：
  
  1.武汉大学中南医院，医学影像科，湖北武汉 430071
  2.武汉大学中南医院，呼吸与危重症医学科，湖北武汉 430071
- 作者简介：
  
  郭杨，男，1997—，医学硕士生，主要从事胸部肿瘤基础及影像诊断研究，E‑mail：1274828536@qq.com
  杜春仙，女，1971—，医学博士，主任医师，主要从事支气管哮喘和肺部恶性肿瘤方面的研究，E⁃mail:duchunxian001@163.com
  廖美焱，男，1968—，医学博士，主任医师，副教授，主要从事肿瘤基础及影像诊断研究，E‑mail：liaomy@whu.edu.cn
- 基金信息：
  
  武汉大学中南医院临床研发项目(lcyf202104)
- DOI：10.14188/j.1671-8852.2024.0756
  中图分类号： R445.3
- 收稿：2024-10-02，
  
  纸质出版：2025-11-25
- 稿件说明：
移动端阅览
郭杨,杜春仙,龙云等.T1期肺腺癌同步脑转移危险因素分析[J].武汉大学学报（医学版）,2025,46(11):1436-1440.

GUO Yang,DU Chunxian,LONG Yun,et al.Analysis of risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma[J].Medical Journal of Wuhan University,2025,46(11):1436-1440.
郭杨,杜春仙,龙云等.T1期肺腺癌同步脑转移危险因素分析[J].武汉大学学报（医学版）,2025,46(11):1436-1440. DOI： 10.14188/j.1671-8852.2024.0756.

GUO Yang,DU Chunxian,LONG Yun,et al.Analysis of risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma[J].Medical Journal of Wuhan University,2025,46(11):1436-1440. DOI： 10.14188/j.1671-8852.2024.0756.

摘要

目的

探讨T1期肺腺癌同步脑转移的危险因素。

方法

回顾性分析2017年8月至2023年10月武汉大学中南医院肺腺癌病例资料，筛选T1期肺腺癌同步脑转移病例，根据肿瘤最大径使用倾向性匹配（PSM）T1期无脑转移病例作为对照组，比较两组病例临床信息及CT影像学资料，使用多因素Logistic回归分析筛选T1期肺腺癌同步脑转移的危险因素。

结果

45例T1期肺腺癌同步脑转移病例纳入研究，PSM匹配对照组45例，单因素分析显示两组间结节‑脊柱距离、血管集束征、表皮生长因子（EGFR）突变状态、血清癌胚抗原（CEA）差异有统计学意义(

0.05)；多因素Logistic回归分析提示EGFR突变状态、CEA是T1期肺腺癌同步脑转移的独立危险因素(

0.05)。

结论

T1期肺腺癌EGFR突变、血清CEA升高是同步脑转移的独立危险因素。

Abstract

Objective

To identify the risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma.

Methods

A retrospective analysis was conducted on lung adenocarcinoma patients treated at Zhongnan Hospital of Wuhan University from August 2017 to October 2023. We screened for T1⁃stage cases with synchronous brain metastasis and

based on tumor maximum diameter

selected T1⁃stage cases without brain metastasis by propensity score matching (PSM) as controls. Clinical characteristics and CT imaging features were compared between the two groups

and risk factors for synchronous brain metastasis were identified using multivariable logistic regression.

Results

Cases of T1 stage lung adenocarcinoma with synchronous brain metastasis were selected

and propensity score matching (PSM) was used to match T1 stage cases without brain metastasis as the control

group based on the maximum tumor diameter. Univariate analysis showed that there were statistically significant differences in nodal‑spinal distance

vascular cluster sign

epidermal growth factor receptor (EGFR) mutation status

and serum carcinoembryonic antigen (CEA) between the two groups （

0.05）. Multivariable logistic regression analysis suggested that EGFR mutation status and CEA were independent risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma（

0.05）.

Conclusion

EGFR mutation and elevated serum CEA were independent risk factors for synchronous brain metastasis in stage T1 lung adenocarcinoma.

关键词

Keywords

references

SUNG H , FERLAY J , SIEGEL R L , et al . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA Cancer J Clin , 2021 , 71 ( 3 ): 209 ‑ 249 .

SIEGEL R L , MILLER K D , JEMAL A . Cancer statistics, 2020 [J ] . CA A Cancer J Clinicians , 2020 , 70 ( 1 ): 7 ‑ 30 .

KINJ R , HOTTINGER A F , BÖHLEN T T , et al . Long‑term results of stereotactic radiotherapy in patients with at least 10 brain metastases at diagnosis [J ] . Cancers (Basel) , 2024 , 16 ( 9 ): 1742 .

WAQAR S N , SAMSON P P , ROBINSON C G , et al . Non–small‑cell lung cancer with brain metastasis at presentation [J ] . Clin Lung Cancer , 2018 , 19 ( 4 ): e373 ‑ e379 .

RICE S R , MOLITORIS J K , VYFHUIS M A L , et al . Lymph node size predicts for asymptomatic brain metastases in patients with non–small‑cell lung cancer at diagnosis [J ] . Clin Lung Cancer , 2019 , 20 ( 1 ): e107 ‑ e114 .

PICHERT M D , CANAVAN M E , MADUKA R C , et al . Revisiting indications for brain imaging during the clinical staging evaluation of lung cancer [J ] . JTO Clin Res Rep , 2022 , 3 ( 5 ): 100318 .

MILLIGAN M G , CRONIN A M , COLSON Y , et al . Overuse of diagnostic brain imaging among patients with stage IA non‑small cell lung cancer [J ] . J Natl Compr Canc Netw , 2020 , 18 ( 5 ): 547 ‑ 554 .

WINSLOW N , BOYLE J , MILLER W , et al . Development of brain metastases in non‑small‑cell lung cancer: High‑risk features [J ] . CNS Oncol , 2024 , 13 ( 1 ): 2395804 .

MOREIRA A L , OCAMPO P S S , XIA Y H , et al . A grading system for invasive pulmonary adenocarcinoma: A proposal from the international association for the study of lung cancer pathology committee [J ] . J Thorac Oncol , 2020 , 15 ( 10 ): 1599 ‑ 1610 .

XIAO H , LIU Y , LIANG P , et al . Predicting malignant potential of solitary pulmonary nodules in patients with COVID‑19 infection: A comprehensive analysis of CT imaging and tumor markers [J ] . BMC Infect Dis , 2024 , 24 ( 1 ): 1050 .

SUN Q , LI P , ZHANG J , et al . CT predictors of visceral pleural invasion in patients with non‑small cell lung cancers 30 mm or smaller [J ] . Radiology , 2024 , 310 ( 1 ): e231611 .

SUH J H , KOTECHA R , CHAO S T , et al . Current approaches to the management of brain metastases [J ] . Nat Rev Clin Oncol , 2020 , 17 : 279 ‑ 299 .

YOO J , PARK H H , KANG S G , et al . Recent update on neurosurgical management of brain metastasis [J ] . Brain Tumor Res Treat , 2022 , 10 ( 3 ): 164 ‑ 171 .

BOIRE A , BRASTIANOS P K , GARZIA L , et al . Brain metastasis [J ] . Nat Rev Cancer , 2020 , 20 ( 1 ): 4 ‑ 11 .

LIN Y , CHEN L , LI R , et al . Survival analysis of patients with advanced non‑small cell lung cancer receiving EGFR‑TKI treatment of Yunnan in southwestern China: A real‑world study [J ] . Front Oncol , 2023 , 13 : 1156647 .

HAN G , BI J , TAN W , et al . A retrospective analysis in patients with EGFR‑mutant lung adenocarcinoma: Is EGFR mutation associated with a higher incidence of brain metastasis? [J ] . Oncotarget , 2016 , 7 ( 35 ): 5 6998‑ 57010 .

BI H , YIN L , FANG W , et al . Association of CEA, NSE, CYFRA 21‑1, SCC‑Ag, and ProGRP with clinicopathological characteristics and chemotherapeutic outcomes of lung cancer [J ] . Lab Med , 2023 , 54 ( 4 ): 372 ‑ 379 .

WU H M , WANG Q M , LIU Q H , et al . The serum tumor markers in combination for clinical diagnosis of lung cancer [J ] . Clin Lab , 2020 , 66 ( 3 ): DOI: 10.7754/Clin.Lab.2019.190533.

CACHO‑DÍAZ B , SPÍNOLA‑MAROÑO H , MENDOZA‑OLIVAS L G , et al . Association of neurologic manifestations and CEA levels with the diagnosis of brain metastases in lung cancer patients [J ] . Clin Transl Oncol , 2019 , 21 ( 11 ): 1538 ‑ 1542 .

GAN T , AN W T , LONG Y , et al . Correlation between carcinoembryonic antigen (CEA) expression and EGFR mutations in non‑small‑cell lung cancer: A meta‑analysis [J ] . Clin Transl Oncol , 2024 , 26 ( 4 ): 991 ‑ 1000 .

ZHANG F R , ZHENG W H , YING L S , et al . A nomogram to predict brain metastases of resected non‑small cell lung cancer patients [J ] . Ann Surg Oncol , 2016 , 23 ( 9 ): 3033 ‑ 3039 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

RAN是肺腺癌的预后标志物并与免疫浸润相关

基于肺腺癌肿瘤标志物建立临床分期诊断模型

伴囊腔的肺癌临床、CT影像特征与术后病理相关性

GPSM1在肺腺癌中的表达及其对肺腺癌细胞糖酵解的调控与潜在机制

常春藤皂苷元对压力超负荷诱导的小鼠心肌肥厚及纤维化的影响