ⅢA/N2期非小细胞肺癌患者淋巴结转移率与预后的相关性  

Correlation between lymph node metastasis rate and prognosis in non-small cell lung cancer patients with stageⅢA/N2

作　　者：陈晓冬[1] 宋永明 Chen Xiaodong;Song Yongming(Department of Thoracic Surgery 1,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院胸外一科,太原030013

出　　处：《肿瘤研究与临床》2021年第1期19-23,共5页Cancer Research and Clinic

摘　　要：目的探讨ⅢA/N2期非小细胞肺癌(NSCLC)患者淋巴结转移率与预后的相关性。方法回顾性分析2012年1月至2015年6月于山西省肿瘤医院接受手术治疗的350例ⅢA/N2期NSCLC患者的临床资料。采用Cox风险回归模型确定淋巴结转移率最佳截断值,依此截断值分为高淋巴结转移率组和低淋巴结转移率组。分析临床病理特征与淋巴结转移率的关系,采用Cox回归模型分析预后危险因素,用Kaplan-Meier法分析高、低淋巴结转移率组患者总生存(OS)和无病生存(DFS)情况。结果淋巴结转移率最佳截断值为0.2。高淋巴结转移率(>0.2)组180例,低淋巴结转移率(≤0.2)组170例。高淋巴结转移率组腺癌、最高淋巴结转移患者比例均高于低淋巴结转移率组[72.2%(130/180)比52.9%(90/170),52.8%(95/180)比29.4%(50/170),均P<0.05]。高淋巴结转移率组跳跃性N2淋巴结转移、N2淋巴结单站转移和最高组N2淋巴结单站转移患者比例均低于低淋巴结转移率组[51.1%(92/180)比71.8%(122/170),25.0%(45/180)比44.1%(75/170),38.9%(70/180)比75.3%(128/175),均P<0.05]。Cox多因素回归模型分析显示,腺癌、多站N2淋巴结转移、淋巴结转移率是ⅢA/N2期NSCLC患者DFS的独立危险因素(HR=2.201,95%CI 1.444~3.355;HR=2.971,95%CI 1.950~4.529;HR=3.543,95%CI 1.874~6.699;均P<0.05);淋巴结转移率是ⅢA/N2期NSCLC患者OS的独立危险因素(HR=3.669,95%CI 1.941~6.938,P<0.05)。低淋巴结转移率组5年OS率(64.00%)高于高淋巴结转移率组(36.58%)(χ^(2)=11.422,P=0.001),低淋巴结转移率组5年PFS率(45.00%)高于高淋巴结转移率组(18.32%)(χ^(2)=13.624,P<0.01)。结论淋巴结转移率是ⅢA/N2期NSCLC患者预后的独立影响因素,能有效评估预后。Objective To explore the correlation between lymph node metastasis rate and prognosis in non-small cell lung cancer(NSCLC)patients with stageⅢA/N2.Methods The clinical data of 350 NSCLC patients with stageⅢA/N2 receiving surgical treatment from January 2012 to June 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed.The patients were divided into the high lymph node metastasis rate group and the low lymph node metastasis rate group according to the optimal cutoff value of lymph node metastasis rate determined by Cox hazard regression model.The relationship between clinicopathological features and lymph node metastasis rate was analyzed.Prognostic risk factors were analyzed by using Cox regression model,and overall survival(OS)and disease-free survival(DFS)of both groups were analyzed by using Kaplan-Meier method.Results The optimal cutoff value of lymph node metastasis rate was 0.2.There were 180 cases with high lymph node metastasis rate(>0.2)and 170 cases with low lymph node metastasis rate(≤0.2).The proportion of the patients with adenocarcinoma and the highest lymph node metastasis in the high lymph node metastasis rate group was higher than that in the low lymph node metastasis rate group[72.2%(130/180)vs.52.9%(90/170),52.8%(95/180)vs.29.4%(50/170),all P<0.05].The proportion of patients with jumping N2 lymph node metastasis,single station N2 lymph node metastasis and single station N2 lymph node metastasis in the highest group was lower than that in the low lymph node metastasis rate group[51.1%(92/180)vs.71.8%(122/170),25.0%(45/180)vs.44.1%(75/170),38.9%(70/180)vs.75.3%(128/175),all P<0.05].Cox multi-factor regression model analysis showed that adenocarcinoma,multiple stations N2 lymph node metastasis,lymph node metastasis rate were independent risk factors of DFS for NSCLC patients with stageⅢA/N2(HR=2.201,95%CI 1.444-3.355;HR=2.971,95%CI 1.950-4.529;HR=3.543,95%CI 1.874-6.699;all P<0.05).Lymph node metastasis rate was an independent risk factor of OS for NSCLC patients with sta

关 键 词：癌 非小细胞肺 淋巴转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]