Objective To investigate the risk factors for lymph node metastasis in cT1N0M0 stage squamous cell lung cancer and develop a logistic regression model to predict lymph node metastasis. Methods A retrospective study was conducted on patients with cT1N0M0 stage lung squamous cell carcinoma in our department from August 2017 to October 2022. The correlation between basic clinical data, imaging data, and pathological data and lymph node metastasis was analyzed. Univariate and multivariate logistic regression analyses were employed for risk factor analysis. Receiver operating characteristic curves and the Hosmer-Lemeshow test were utilized to evaluate the model’s discrimination and calibration. The Bootstrap method with 1 000 resamples was employed for internal validation of the model. Results Tumor location of central-type, tumor differentiation, cytokeratin 19 fragment (CYFRA21-1) levels, and tumor size were independent risk factors for lymph node metastasis in cT1N0M0 stage squamous cell lung cancer. The optimal cutoff values for tumor size and CYFRA21-1 levels were determined to be 2.05 cm and 4.20 ng/mL, respectively. The combination of tumor location, CYFRA21-1 levels, and tumor size demonstrates superior predictive capability compared to any individual factor. Conclusion Tumor location of central-type, poorly differentiated tumors, CYFRA21-1 levels, and tumor size are risk factors for lymph node metastasis in cT1N0M0 stage lung squamous cell carcinoma. The combined predictive model has certain guiding significance for intraoperative lymph node resection strategies in cT1N0M0 stage lung squamous cell carcinoma.
IgG4-related disease (IgG4-RD) is a chronic, immune-mediated inflammatory and fibrotic condition that can affect virtually any organ system. While some patients experience involvement of only a single organ, isolated IgG4-RD of the mediastinum is even rarer. This article reports a case of a 48-year-old male patient with isolated IgG4-RD of the middle mediastinum. After a biopsy failed to establish a definitive diagnosis, the patient underwent a right thoracotomy-assisted mediastinal tumor resection via video-assisted thoracoscopic surgery. The tumor was completely resected during the procedure, which lasted 130 minutes, with an estimated blood loss of approximately 50 mL. The patient had a favorable postoperative course and satisfactory clinical outcome. No glucocorticoid or other medical treatment was administered postoperatively, and there was no recurrence during a 6-month follow-up period.
