肺腺癌新分类在预测Ⅰb期非小细胞肺癌预后中的价值  

The Predictive Value of New Lung Adenocarcinoma Classification on the Prognosis of Non-small Cell Lung Cancer Stage Ⅰb

作　　者：曹玉娟[1] 王德林[1] 刘承伟[1] 杜芳[1] 郝龙英[1] 曹凤[1] 李伟伟[1] 赵聪[1] 

机构地区：[1]北京大学首钢医院,北京100144

出　　处：《肿瘤学杂志》2014年第6期448-451,共4页Journal of Chinese Oncology

摘　　要：[目的]探讨新的肺腺癌分类在判断早期可手术的Ⅰb期非小细胞肺腺癌患者中的预后价值。[方法]回顾性分析168例非小细胞肺癌患者,根据第7版TNM分期明确诊断为Ⅰb期非小细胞肺腺癌。采用Kaplan-Meier法比较不同病理亚型患者的无复发生存期和总生存期。Cox回归分析探讨影响患者无复发生存期和总生存期的影响因素。[结果]168例患者中,无原位腺癌患者,2例患者为微浸润腺癌,51例患者为乳头状为主型,55例患者为腺泡样为主型,24例为微乳头为主型,20例为鳞屑状为主型,12例为实性为主型腺癌,4例为变异性腺癌(其中2例为实性腺癌,2例为胎儿型腺癌)。单因素分析显示,是否淋巴管/血管侵犯(P=0.042)和不同病理类型(P=0.004)是影响患者5年无复发生存的因素。多因素分析显示,病理类型是同时影响患者5年无复发生存和总生存期的惟一因素(P分别为0.002和0.035)。[结论]新肺腺癌分类在预测可手术的Ⅰb期非小细胞肺腺癌的无复发生存和总生存方面有一定的价值。[ Purpose ] To investigate the relationship between new Lung Adenocarcinoma Classification and prognosis of lung adenocarcinoma stage Ⅰb. [Methods] One hundred and sixtyeight patients with stage I lung adenocarcinoma operated in Peking University Shougang Hos- pital,were identified between 2000 and 2010. Survival curves were plotted using the Kaplan- Meier method. The Cox proportional hazard model was used for multivariate analysis. [Results] None of the cases were adenocarcinoma in situ and two were minimally invasive adenocarcinomas. One hundred and sixty-six cases were invasive adenocarcinoma. Of those,51,55,24,12,20 and 4 were papillary predominant,acinar predominant,micropapillary predominant,solid predomi- nant,lepidic predominant subtypes, and variants of invasive adenocarcinoma,respectively. Pa- tients with micropapillary and solid predominant tumors had a significantly worse disease-free survival as compared to those with other subtypes predominant tumors （P〈0.001）. Multivariate analysis revealed that the new classification was an independent predictor of the disease-free and overall survival （P=-0.002 and 0.035）. [Conclusion] The predominant subtype in the primary tumor is associated with prognosis of resected lung adenocarcinoma stage Ⅰ.

关 键 词：癌 非小细胞肺 腺癌新分类 预后 

分 类 号：R734.2[医药卫生—肿瘤]