目的:探究诊断–手术时间间隔对I期部分实性或实性密度结节肺腺癌患者预后的影响,并分析其与术后病理高危因素之间的关系。方法:通过回顾性分析2018年6月至2019年6月I期肺腺癌患者的临床数据,采用RCS方法探究手术间隔时间与生存结果之间的关系,以RCS图线中拐点为分界,将患者分为A组(n = 293)与B组(n = 234),采用Kaplan-Meier法绘制生存曲线评估二组差异,采用倾向性得分匹配后控制变量后重复Kaplan-Meier法绘制生存曲线。通过Wilcoxon秩和检验评估两组手术时间、住院时间及带管时间是否存在差异。采用Logistic回归分析,探讨诊断–手术时间间隔与病理高危因素之间的关联性。结果:共收集527例临床诊断为I期的肺腺癌患者,RCS图示拐点为8周,患者复发风险8周后都随诊断–手术时间间隔的延长而增加。诊断时间间隔与DFS行单因素COX分析得,二者之间存在相关(HR, 1.57, 95% CI, 0.95~2.59, P = 0.076)。倾向性得分匹配后可见A组无病生存期及总生存期都强于B组,且存在统计学意义。诊断–手术间隔时间延长会导致脉管癌栓出现的可能性增加(OR 2.35, 95% CI, 1.01~5.47, P = 0.048),对胸膜侵犯(OR, 1.226, 95% CI, 0.485~3.099, P = 0.667)及气道播散(OR, 1.247, 95% CI, 0.631~2.465, P = 0.526)的出现与否的影响无统计学意义。结论:诊断–手术时间间隔超过8周会导致患者远期预后不良。诊断–手术间隔的延长可能会导致脉管癌栓出现,从而影响患者远期预后。Objective: To investigate the impact of the diagnosis-to-surgery interval (DSI) on the prognosis of patients with stage I lung adenocarcinoma presenting as part-solid or solid density nodules and analyze its association with postoperative pathological high-risk factors. Methods: By retrospectively analyzing the clinical data of stage I lung adenocarcinoma patients from June 2018 to June 2019, the relationship between the surgery interval and survival outc
