肺腺鳞癌外科疗效分析  

Clinical outcomes of primary adenosquamous carcinoma of the lung treated by surgery

作　　者：杨海堂[1] 姚烽[1] 孙益峰[1] 余科科[2] 顾海勇[1] 陈天翔[1] 赵珩[1] 

机构地区：[1]上海交通大学附属胸科医院胸外科,200030 [2]上海交通大学附属胸科医院病理科,200030

出　　处：《中华胸部外科电子杂志》2015年第3期161-167,共7页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的探讨分析原发性肺腺鳞癌（ASC）临床病理特征及预后因素。方法回顾性分析上海市胸科医院胸外科2008年10月至2014年12月术后病理证实为原发性肺ASC患者的临床资料。分别分析ASC患者3年和5年的总生存率以及5年无病生存率，采用单因素和多因素分析影响总生存期和无病生存期的预后因素。结果该研究共有205例ASC患者纳入分析，其中男性145例（70．7％），女性60例（29．3％）；年龄21～70岁，平均年龄（60．7±9．7）岁。NO、N1和N2期（NOvsN1，P=0．031；N1vsN2，P=0．037）之间以及I、Ⅱ和ⅢA期（IvsⅡ，P=0．021；ⅡvsⅢA，P=0．007）患者之间预后均有统计学差异。Cox多因素回归分析表明：肿瘤T分期（P=0．011）、TNM分期（P〈0．001）以及辅助化疗（P=0．008）是总生存期的独立预后因素；而TNM分期（P〈0．001）和辅助化疗（P=0．005）是预测相应无病生存期的独立因素。结论ASC患者的预后与肿瘤的T分期和TNM分期有关；术后辅助化疗能提高ASC患者的生存。Objective To analyze the clinicopathological characteristics and prognostic factors associated with primary adenosquamous carcinoma （ASC） of the lung. Methods The clinical data of patients with ASC of the lung confirmed by postoperative pathology between October 2008 and December 2014 in Shanghai Chest Hospital were retrospectively analyzed. The 3-year overall survival, 5-year overall survival and 5-year disease-free survival of patients was analyzed, and the prognostic factors for overall survival and disease-flee survival were explored by univariate analysis and multivariate analysis. Results A total of 205 patients were identified, including 145 （70.7%） males and 60 （9.3%） females with an average age of （60.7±9.7） years （range 21-70 years）. There were significant differences in the prognosis among patients with NO, N1 and N2（N0 vs N1, P=0. 031; N1 vs N2, P=0. 037） and among patients with Ⅰ , Ⅱ and ⅢA（ Ⅰ vs Ⅱ , P=0.021; Ⅱ vs ⅢA, P=0.007）. Cox multivariate analysis demonstrated that T stage of tumor（P=0. 011）, TNM stage （P〈0. 001） and adjuvant chemotherapy（P =0. 008） were independent prognostic factors for overall survival, and TNM stage （P〈0. 001） and adjuvant chemotherapy （P = 0. 005） were independent prognostic factors for disease-free survival. Conclusions The prognosis of ASC is associated with T stage and TNM stage, and postoperative adjuvant chemotherapy can increase the survival of patients with ASC.

关 键 词：腺鳞癌 外科治疗 生存 

分 类 号：R734.2[医药卫生—肿瘤]