ⅢA（N2）期NSCLC术后预后因素分析  

An analysis of prognostic factors for stage ⅢA （N2） non-small cell lung cancer after complete resection

作　　者：刘月姣[1] 李晓敏[1] 武静[1] 李琦[1] 武亚娟[1] 任雅琼[1] 任跃君[1] 

机构地区：[1]太原山西医科大学附属肿瘤医院山西省肿瘤医院放疗科,030013

出　　处：《中华放射肿瘤学杂志》2016年第10期1057-1061,共5页Chinese Journal of Radiation Oncology

摘　　要：目的：研究ⅢA（ N2）期NSCLC患者术后转移、复发及生存的相关因素，为患者术后选择放疗提供客观依据。方法收集本院2009—2013年间完全手术切除、术后分期为ⅢA （ N2）的NSCLC患者资料199例，用 Cox 模型进行转移、复发多因素分析，用 Kaplan-Meier 法生存分析并Logrank检验。结果199例患者中有完整随访资料的173例，1、2年转移率，复发率和生存率分别为38.7％、52.6％，27.8％、39.1％和92.5％、51.4％。多因素分析发现病理类型、术前CEA／CY211／SCC中两项阳性是转移的危险因素（ P＝0.013、0.014），阳性淋巴结数、淋巴结转移站数、淋巴结转移率、术前CEA／CY211／SCC中两项阳性是复发危险因素（ P＝0.046、0.004、0.028、0.001）。相应患者的生存率下降（ P＝0.013、0.011、0.002、0.026）。结论阳性淋巴结数、淋巴结转移站数、淋巴结转移率及术前CEA／CY211／SCC中两项阳性的ⅢA（ N2）期NSCLC患者行术后放疗可能获益。Objective To investigate the factors associated with postoperative metastasis, recurrence, and survival in patients with stage ⅢA （ N2 ） non.small cell lung cancer （ NSCLC ） , and to provide an objective basis for postoperative radiotherapy in patients. Methods Clinical data were collected from 199 patients who underwent complete resection and were diagnosed with stage ⅢA （ N2 ） NSCLC after surgery in our hospital from 2009 to 2013. The Cox regression model was used for the multivariate analyses of metastasis and recurrence. The survival rates were calculated using the Kaplan.Meier method and analyzed using the log-rank test. Results In the 199 patients, 173 had complete follow-up data. The 1-and 2-year metastasis, recurrence, and survival rates were 38.7%/52.6%, 27.8%/39.1%, and 92.5%/51.4%, respectively. The multivariate analysis showed that pathological type and two positive indices among preoperative CEA/CY211/SCC were two risk factors for metastasis （ P=0.013,0.014） . Positive lymph node number, metastatic lymph node number, lymph node metastasis rate, and two positive indices among preoperative CEA/CY211/SCC were risk factors for recurrence （ P=0.046,0.004,0.028,0.001） . All the above indices were risk factors for low survival rates （ P= 0.013 , 0.011 , 0.002,0.026 ） . Conclusions Patients with stage ⅢA （ N2 ） NSCLC who have positive lymph nodes, lymph node metastases, and two positive indices among preoperative CEA/CY211/SCC may benefit from postoperative radiotherapy.

关 键 词：癌 非小细胞肺/外科学 肿瘤转移 术后 肿瘤复发 术后 选择放疗 

分 类 号：R734.2[医药卫生—肿瘤]