脏层胸膜浸润对术后早期非小细胞肺癌患者预后的影响  

Influence of visceral pleural invasion on prognosis of patients with early non-small cell lung cancer after operation

作　　者：张慧[1] 邵国光[2] 闫旭[3] 孙宏伟[1] 王星星[1] 邵铭心 马克威[1] 

机构地区：[1]吉林大学第一医院肿瘤中心,吉林长春130021 [2]吉林大学第一医院胸外科,吉林长春130021 [3]吉林大学第一医院病理科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2014年第2期369-373,共5页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(81372870)

摘　　要：目的：研究术后早期非小细胞肺癌（NSCLC）患者的脏层胸膜浸润（VPI）情况，阐明VPI对NSCLC患者预后的影响。方法：门诊随访2007—2011年本院经外科根治性术后病理分期为Ⅰ～Ⅱ期NSCLC患者261例，中位随访时间36个月，将患者分为VPI组（130例）和无VPI组（131例），采用X^2检验或Fisher精确概率法进行分类变量分析；Kaplan—Meier法估算患者无疾病生存率和总生存率，采用COX比例风险模型分析患者临床特征与预后的关系。结果：VPI组患者1年总生存率为90．77％，无VPI组患者1年总生存率为93．13％，组间比较差异无统计学意义（P〉0．05）。VPI组患者3和5年总生存率（69．23％和63．85％）低于无VPI组（80．15％和74．05％）（P〈0．05）。COX单因素及多因素分析，年龄、肿瘤大小和VPI是影响NSCLC患者无疾病生存期（DFS）和总生存期（OS）的独立预后因素（P〈O．05）。结论：VPI是术后早期NSCLC患者不良预后因素之一，对肿瘤临床病理分期标准有影响。Objective To study the visceral pleural invasion （VPI） situation of the patients with early postoperative non-small cell lung cancer （NSCLC）, and to clarify its influence in prognosis of NSCLC patients. Methods 261 NSCLC patients were followed up in outpatient department who were diagnosed as the pathologic stage Ⅰ～Ⅱafter surgical radical operation from 2007 to 2011. The median follow-up time was 36 months. All the patients were divided into VPI group（n= 130） and non-VPI group（n= 131）. X^2 test or Fisher exact test was used to analyze the categorical variables; Kaplan-Meier method was used to estimate the disease-free survival（DFS） rate and overall survival（OS） rate; COX proprotional hazards model was used to analyze the relationship between the clinical characteristic and prognosis of NSCLC patients. Results The 1-year OS rate of the patients in VPI group was 90.77%, meanwhile it was 93.13% in non-VPI group, there was no significant difference between two groups （P〉0.05）. The 3-year and 5-year OS rates （69.23% and 63.85%） of the patients in VPI group were lower than those in non-VPI group （80.15% and 74.05%）（P〈0.05）. COX unuvariate and multivariate analysis indicated that age, tumor size, and VPI were the influnencing factors of DFS and OS of the NSCLC patients （P〈0.05）.Conclusion VPI is one of the poor prognostic factors of early postoperative NSCLC patients, and it plays an role in criteria of tumor clinicopathological stage.

关 键 词：癌 非小细胞肺 脏层胸膜浸润 预后 总生存期 无疾病生存期 

分 类 号：R734.2[医药卫生—肿瘤]