意外性N1期与临床性N1期非小细胞肺癌患者临床特征及预后对比  

Comparison of clinical features and prognosis in patients with accidental N1 phase and expected N1 phase of non-small cell lung cancer

作　　者：李冠燃[1] 方原[1] 汪洋[1] 张庆华[2] Li Guanran;Fang Yuan;Wang Yang;Zhang Qinghua(Department of Thoracic Surgery, Dalian Central Hospital, Dalian 116033, China)

机构地区：[1]辽宁省大连市中心医院胸外一科,116033 [2]大连医科大学附属第一医院心血管外科

出　　处：《中国综合临床》2018年第4期322-325,共4页Clinical Medicine of China

摘　　要：目的对比分析意外性N1期与临床性N1期非小细胞肺癌（non-small cell lung cancer，NSCLC）患者的临床特征及预后情况。方法对2008年1月至2012年6月术后病理确诊pT1-3N1M0期NSCLC176例患者进行回顾性分析，其中意外性N1期（cN0～pN1）NSCLC 75例（意外组），临床性N1期（cN1～pN1）NSCLC 101例（临床组），对两组的临床特征、转移复发、生存时间及1、3、5生存率进行统计学比较。结果意外组患者肿瘤直径、T分期、淋巴结转移的数量及站数与临床组比较差异均有统计学意义（P均〈0.05）。意外组患者局部复发率为10.7%（8/75），较临床组21.8%（22/101）明显降低，差异有统计学意义（χ^2＝7.988，P＝0.039）。意外组患者生存时间（46.8±5.5）个月，较临床组（29.7±4.9）个月明显延长（t＝8.665，P＝0.029），意外组患者1、3、5年生存率分别为85.3%（64/75）、57.3%（43/75）、42.7%（32/75），均较临床组的73.3%（74/101）、43.6%（44/101）、28.7%（29/101）明显升高（χ^2值分别为6.089、7.490、9.112，P均〈0.05）。结论临床表现不同N1期NSCLC患者具有一定程度的异质性，意外性N1期NSCLC患者较临床性N1期NSCLC患者在局部复发、远期生存方面优势明显。Objective To compare the clinical features and prognosis in patients with accidental N1 phase and expected N1 phase of non-small cell lung cancer（NSCLC）.Methods Retrospective analysis was performed on the one hundred and seventy-six NSCLC patients who underwent surgery and were pathologically diagnosed with Pt1-3N1M0 phase NSCLC from January 2008 to June 2012.Among them, there were 75 patients with accidental N1 disease （Cn0-Pn1） NSCLC （accidental group）, and 101 patients with expected N1 disease（Cn1-Pn1） NSCLC （clinical group）. The clinical features, metastasis and recurrence, survival time, 1, 3, 5-year survival rates of the two groups were analyzed.Results There were significant differences in tumor diameter, pathologic T staging, the number of lymph node metastasis and the number of stations between the two groups （P〈0.05）. The local recurrence rate of the patients in the accident group was 10.7% （8/75）, which was significantly lower than that in the clinical group 21.8% （22/101）, and the difference was statistically significant （χ^2=7.988, P=0.039）. The survival time of accidental group was （46.8±5.5） months, compared with the expected group （（29.7±4.9） months）, it was obviously prolonged （t=8.665, P=0.029）. The 1, 3 and 5 year survival rates in the accident group were 85.3% （64/75）, 57.3% （43/75）, 42.7% （32/75）, respectively, which were significantly higher than those in the clinical group （73.3% （74/101）, 43.6% （44/101）, 28.7% （29/101）） （χ^2=6.089, 7.490, 9.112, P〈0.05）.Conclusion The clinical manifestations are different.N1 phase NSCLC patients have a certain degree of heterogeneity.Accidental N1 phase NSCLC patients have obvious advantages in local recurrence and long-term survival than those with clinical N1 phase NSCLC.

关 键 词：非小细胞肺癌 肿瘤分期 淋巴转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]