目的：探讨影响原发性肺腺癌淋巴结转移的影响因素用以预测患者淋巴结转移情况，以期对术中淋巴结清扫范围的选择及指导术后治疗提供帮助。方法：回顾性分析229例原发性肺腺癌患者的临床资料，患者经肺叶切除术或亚肺叶切除（肺段及楔形切除），且均行系统淋巴结清扫或采样。对其淋巴结转移情况以及影响淋巴结转移相关因素进行单因素和Logistic多因素分析。结果：229例患者中发生淋巴结转移52例（22.7%），单因素分析显示，肿瘤直径、病理亚型、术前癌胚抗原（CEA）水平、细胞核增值抗原（Ki67）表达量、CT值等为影响淋巴结转移的因素（P<0.05）；Logistics多因素分析显示患者的肿瘤直径（OR=1.859，95%CI=1.328~2.601，P=0.001）、术前CEA水平（OR=1.009，95%CI=1.038~1.164，P=0.001）是患者淋巴结发生转移的独立危险因素。结论：肺腺癌患者的术前CEA水平、肿瘤直径是淋巴结转移的独立危险因素，对淋巴结转移有很好的预测作用。

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