近年来,肺结节的关注度逐年升高.被问最多的问题就是:"医生,我是不是得肺癌了?我该怎么办?"可见,肺结节已给越来越多的患者带来了焦虑情绪和心理负担. 九成肺结节为良性 肺结节是一个CT影像学上的概念,是在CT图像上呈现的异常病灶.通常可分为实性结节、混合磨玻璃结节和纯磨玻璃结节.它的具体病理性质可以是肿瘤,可以是炎症、结核、良性肿瘤,也可以是细菌感染、真菌感染,甚至是自身的血管畸形、淋巴结等.

Objective Identify risk factors of N1 lymph node metastasis in clinical stage l non-small cell lung cancer,to try to improve the accuracy of preoperative N staging and help make treatment decision.Methods Records of patients with clinical stage Ⅰ NSCLC who had undergone pulmonary resection with systematic node dissection at Peking University People' s Hospital between September 2006 and December 2013 were retrospectively reviewed.To identify risk factors for N1 node metastasis,univariate and multivariate logistic regression analyses were performed.Results Among the 612 patients eligible for this study,intrapulmonary lymph node(N1) metastasis occurred in 59 patients(9.6％).In univariate analysis,7 risk factors were identified:male,cigarette smokers,tumor size,tumor location(central),non-adenocarcinoma,tumor differentiation degree and microvascular invasion.In multivariate analysis,3 independent risk factors were identified:tumor size(OR =1.903,P ＜ 0.01),tumor differentiation degree (OR =2.591,P ＜ 0.01) and microvascular invasion (OR =6.170,P ＜ 0.01).Through the analysis of ROC curve,the optimal cutoff point of tumor size was 2 cm,the N1 transfer rate was 4.9％ when tumer size ≤2 cm,the rate was 15.0％ when tumer size ＞ 2 cm.Conclusion The prevalence of N1 nodal metastasis in clinical stage Ⅰ NSCLC patients was 9.6％.Tumor size,tumor differentiation degree and microvascular invasion were identified as 3 independent predictive risk factors for N1 nodal metastasis in clinical stage Ⅰ NSCLC patients.Patients of clinical stage Ⅰ NSCLC with tumor size ＞ 2 cm were recommended to receive further N staging procedures(PET/CT or EBUS-TBNA) before surgery to attain a more accurate N stage.

据调查,我国的吸烟人数位居世界第一,烟草的供应量和消费量也是世界第一.科学研究表明,吸烟不仅是一种不良行为,更是一种慢性疾病. 吸烟是对人类健康威胁最大的杀手 在已知个人生活习惯里,烟、酒是人类健康的杀手.酗酒可增加肝硬化、肝癌及脑卒中等疾患的发生风险,不过其对健康的危害程度相对于吸烟则是小巫见大巫了.吸烟是对人类健康威胁最大的杀手:全世界每年大约有300万人因吸烟而导致死亡,我国每年因吸烟导致死亡的人数为60万～80万.吸烟会对人体的呼吸、心血管、消化、泌尿等多个系统及器官造成损害,其中以呼吸系统,尤其是肺脏受害尤甚.