肺段切除治疗磨玻璃影为主早期肺癌的围术期及远期效果:单中心大样本回顾性研究  

Perioperative and long-term outcomes of segmentectomy for ground-glass opacity dominant early stage lung cancer: A single-center large-sample retrospective analysis

作　　者：杨振宇[1] 刘成武[1] 梅建东[1] 周健[1] 朱云柯[1] 林锋[1] 廖虎[1] 马林[1] 刘铮 郭成林[1] 蒲强[1] 刘伦旭[1] YANG Zhenyu;LIU Chengwu;MEI Jiandong;ZHOU Jian;ZHU Yunke;LIN Feng;LIAO Hu;MA Lin;LIU Zheng;GUO Chenglin;PU Qiang;LIU Lunxu(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2021年第12期1420-1426,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川大学华西医院1·3·5学科卓越发展基金(ZYGD18021,ZYJC18009)。

摘　　要：目的分析解剖性肺段切除手术治疗以磨玻璃影(ground-glass opacity,GGO)为主早期肺癌的围术期效果及远期预后。方法从我科前瞻性建设的中国西部肺癌数据库中收集2009~2018年行意向性解剖性肺段切除肺癌756例患者[肿瘤直径(T)≤2cm、GGO≥50%]的数据,分析围术期及远期疗效。男233例、女523例,中位年龄53(25~83)岁。其中简单肺段290例(38.4%),复杂肺段466例(61.6%)。所有患者术后病理诊断均为腺癌,其中微浸润型腺癌338例(44.7%),浸润型肺腺癌418例(55.3%)。结果中位手术时间115(38~300)min,中位术中失血量20(5~800)mL,中位术后住院时间4(2~24)d,术后并发症58例(7.7%),无围术期死亡。全组中位随访时间为43.0(30.1~167.9)个月。5年总生存率99.5%[95%CI(98.8%,100.0%)],5年无复发生存率98.8%[95%CI(97.5%,100.0%)],5年肺癌特异性生存率100.0%。结论肺段切除在GGO为主的早期肺癌患者中具有良好的围术期效果和极佳的远期生存。Objective To summarize the perioperative and long-term outcomes of ground-glass opacity(GGO dominant early stage lung cancer patients treated by anatomic segmentectomy. Methods We collected clinical data of 756 patients from Western China Lung Cancer Database, who underwent intentional anatomic segmentectomy [tumor size(T) ≤ 2 cm, GGO ≥ 50%] in the Department of Thoracic Surgery, West China Hospital, Sichuan University from 2009 to 2018. There were 233 males and 523 females at a median age of 53(25-83) years including 290(38.4%) patients of simple segmentectomy and 466(61.6%) patients of complex segmentectomy. All patients were diagnosed as adenocarcinoma, including 338(44.7%) patients of minimally invasive adenocarcinoma and 418(55.3%) patients of invasive adenocarcinoma. Results The median operative time was 115(38-300) min, the median blood loss was 20(5-800) mL, 58(7.7%) patients had postoperative complications and the postoperative stay was 4(2-24) days. The median follow-up period was 43.0(30.1-167.9) months. Five-year overall survival rate was 99.5% [95%CI(98.8%, 100.0%)], 5-year recurrence-free survival rate was 98.8% [95%CI(97.5%, 100.0%)], and 5-year lung cancer-specific survival rate was 100.0%.Conclusion Anatomic segmentectomy has favorable perioperative outcomes and excellent prognosis in GGO dominant early stage lung cancer patients.

关 键 词：肺段切除 磨玻璃影结节 肺癌 预后 手术 

分 类 号：R734.2[医药卫生—肿瘤]