ⅢA-N2期非小细胞肺癌N2淋巴结跳跃转移的临床分析  

Clinical analysis of N2 skip metastases in stageⅢA-N2 non-small-cell lung cancer

作　　者：谭林[1] 梁效民[1] 王琛[2] 郝万明[3] 王东飞 Tan Lin;Liang Xiaomin;Wang Chen;Hao Wanming;Wang Dongfei(Department of Thoracic Surgery,Qingdao Municipal Hospital,Qingdao 266071,China;Department of Critical Care Medicine,Qingdao Municipal Hospital,Qingdao 266071,Chin a;Department of Respiratory and Critical Medicine,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛市市立医院胸外科,山东青岛266071 [2]青岛市市立医院重症医学科,山东青岛266071 [3]青岛市市立医院呼吸与危重症医学科,山东青岛266071

出　　处：《实用肿瘤杂志》2020年第6期501-505,共5页Journal of Practical Oncology

基　　金：山东省医药卫生科技发展计划项目(2017WS309)。

摘　　要：目的探讨N2淋巴结跳跃转移与ⅢA-N2期非小细胞肺癌(non-small-cell lung cancer,NSCLC)临床病理特征和生存的关系。方法回顾性分析155例手术治疗且术后病理证实为ⅢA-N2期NSCLC患者的临床资料,其中N2淋巴结跳跃转移患者(N2跳跃转移组)43例,无跳跃转移患者(N2非跳跃转移组)112例。采用四格表χ^2检验分析N2淋巴结跳跃转移与各临床病理特征的相关性,采用Kaplan-Meier法进行生存分析,Log-rank检验生存率差异,Cox多因素分析各因素对生存率的影响。结果N2淋巴结跳跃转移与病理类型有关(χ^2=7.974,P=0.019)。N2跳跃转移组的生存情况优于N2非跳跃转移组(5年生存率:44.2%vs 24.1%,P=0.025;中位无瘤生存时间:41个月vs 29个月,P=0.042)。跳跃转移为患者术后生存时间的独立影响因素(P=0.047)。在亚组分析中,跳跃转移、N2阳性淋巴结单站转移、N2阳性淋巴结数目≤3枚及肿瘤大小≤3 cm的ⅢA-N2期NSCLC患者,术后生存时间均较长(均P<0.05)。结论伴有跳跃转移的ⅢA-N2期NSCLC患者术后具有更高的生存率。Objective To investigate the correlation between N2 skip metastases and the clinicopathological features and prognosis of stageⅢA-N2 non-small-cell lung cancer(NSCLC).Methods The clinical data of 155 NSCLC patients undergoing surgical treatment and postoperative pathology confirmed as stageⅢA-N2 NSCLC were retrospectively analyzed.There were 43 patients with N2 skip metastasis(N2 skip metastasis group)and 112 patients with N2 non-skip metastasis(N2 non-skip metastasis group).Theχ^2 test of four grids was used to analyze the correlation between N2 skip metastasis and various clinicopathological characteristics.The Kaplan-Meier method was used for survival analysis,the Log-rank test was used to test the difference in survival rate,and the Cox multivariate analysis of the influence of each factor on survival rate.Results N2 skip metastasis was associated with squamous cell carcinoma(χ^2=7.974,P=0.019).The survival of the N2 skip metastasis group was better than that of the N2 non-skip metastasis group(5-year survival rate:44.2%vs 24.1%,P=0.025;the median disease-free survival:41 months vs 29 months,P=0.042).Skip metastasis was an independent factor of postoperative survival(P=0.047).The subgroup analysis showed that stageⅢA-N2 NSCLC patients with skip metastasis and single-site N2-positive lymph node metastasis,the number of N2-positive lymph nodes≤3,and the tumor size≤3 cm had longer postoperative survival time(all P<0.05).Conclusion StageⅢA-N2 NSCLC patients with skip metastasis have longer survival after surgery.

关 键 词：非小细胞肺癌 N2淋巴结跳跃转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]