病理Ⅰ_A期非小细胞肺癌患者术后预后因素分析  

Prognostic Factors for Patients with Stage Ⅰ_A Non-small Cell Lung Cancer after Operation

作　　者：冯宏响[1] 张真榕[1] 郭永庆[1] 石彬[1] 宋之乙[1] 田燕雏[1] 梁朝阳[1] 刘德若[1] 

机构地区：[1]中日友好医院胸外科,北京100029

出　　处：《中国胸心血管外科临床杂志》2016年第10期969-973,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家临床重点专科建设项目([2011]873)~~

摘　　要：目的 分析术后病理Ⅰ_A期非小细胞肺癌患者的临床病理特征,探讨影响其预后的危险因素。方法回顾性分析我科1993年1月至2012年12月术后病理证实为Ⅰ_A期的非小细胞肺癌患者138例的临床资料,其中男81例、女57例,年龄37～80岁,中位年龄61岁。收集相关住院临床资料和随访资料。绘制Kaplan-Meier生存曲线,采用Cox比例风险模型进行单因素和多因素分析,评价各因素对无病生存的影响。结果 随访时间9～90个月,中位随访时间为59个月。随访过程中患者出现复发转移14例（10.1%）,局部复发8例,同时发现骨转移和同侧肺门淋巴结增大1例。单因素分析显示脉管浸润（P=0.017）、病理低分化（P=0.043）、肿瘤直径≥2 cm（T1b,P=0.017）是预后不良的危险因素。多因素分析表明脉管侵犯（P=0.011）和肿瘤的直径≥2 cm（T1b,P=0.026）是Ⅰ_A期非小细胞肺癌患者预后不良的独立危险因素。结论 脉管浸润和肿瘤直径是Ⅰ_A期非小细胞肺癌患者预后的独立危险因素。Objective To identify prognostic factors for patients with non-small cell lung cancer （NSCLC） in patho- logic stage I A after operation. Methods We retrospectively analyzed the clinical data of 138 patients, who underwent surgical resection at our institution for stage IA NSCLC. There were 81 males and 57 females with a median age of 61 years （ranged from 37 to 80 years）. The in-hospital data and follow-up results were collected. Survival curve was generated by Kaplan-Meier method. Univariate and multivariate analyses of disease-free survival （DFS） were performed. Results The follow-up time was from 9 to 90 months with a median of 59 months. During the follow-up, recurrence and metastasis occurred in 14 patients, local relapse in 8 patients, bone and ipsflateral lymph node metastasis occurred in one patient. Univariate analysis showed that DFS of patients was related with blood vessel or lymphatic invasion （P=0.017）, poor histological differentiation （P=0.043）, and tumor diameter ≥ 2 cm （P=0.017）, respectively. Multivariate analysis demonstrated that tumor diameter ≥ 2 cm （P=0.026） and blood vessel or lymphatic invasion （P=0.011） were independent prognostic factors for DFS of stage I A NSCLC patients after operation. Conclusion Our analyses indicate vessel involvement and the tumor diameter are independent indicators of DFS in patients with pathologic stage I A NSCLC after operation.

关 键 词：非小细胞肺癌 预后 脉管浸润 

分 类 号：R734.2[医药卫生—肿瘤]