术后意外的小细胞肺癌生存分析  

Survival analysis of unexpected small cell lung cancer following surgery

作　　者：郭俊唐[1] 申磊磊 梁朝阳[1] 柳曦[1] 张涛[1] 马永富[1] 刘阳[1] Guo Juntang;Shen Leilei;Liang Chaoyang;Liu Xi;Zhang Tao;Ma Yongfu;Liu Yang(Department of Thoracic Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Thoracic Surgery,Hainan Hospital,Chinese PLA General Hospital,Sanya 572000,China)

机构地区：[1]解放军总医院第一医学中心胸外科,北京100853 [2]解放军总医院海南医院胸外科,三亚572000

出　　处：《中华肿瘤杂志》2022年第6期550-554,共5页Chinese Journal of Oncology

摘　　要：目的探讨术后意外的小细胞肺癌患者预后情况。方法回顾性分析2000年1月至2020年10月在解放军总医院第一医学中心经手术治疗术后病理意外证实为小细胞肺癌患者(104例)的临床病理资料。生存分析采用Kaplan-Meier法和Log rank检验,多因素分析采用Cox回归模型。结果104例患者中,27例为中央型肺癌,77例为周围型肺癌。CT示结节边缘光滑42例。全组患者中位生存时间为34.3个月,5年生存率为45.8%,Ⅰ期、Ⅱ期和Ⅲ期患者5年生存率分别为52.1%、45.4%和27.8%。年龄、手术入路、手术方式、N分期、TNM分期及脉管癌栓与患者总生存有关(均P<0.05)。N分期是患者总生存的独立影响因素(P<0.05)。结论Ⅰ期、Ⅱ期和部分ⅢA期的小细胞肺癌患者均能从手术中获益,推荐行标准的肺叶切除加系统性淋巴结清扫术。Objective To investigate the survival and influencing factors of unexpected small cell lung cancer following surgery.Methods We respectively reviewed the clinical characters of 104 patients who underwent surgical treatment and be proved as small cell lung cancer by pathology between January 2000 to October 2020 in Chinese PLA General Hospital.Overall survival(OS)of patients was evaluated using Kaplan-Meier and Cox proportional hazards analysis.Results Of 104 patients,27 cases showed central lesions,and other 77 showed peripheral nodules.The margin of nodules was smooth in 42 cases on CT imaging.The median OS was 34.3 months and 5-year OS rate was 45.8%.Postoperative 5-year OS rates for patients were 52.1%,45.4%,and 27.8%for clinical stagesⅠ,Ⅱ,andⅢ,respectively.Univariate analyses identified the age,surgical access,surgical approach,N stage,TNM stage and vascular cancer emboli were associated with OS(P<0.05).The N stage was an independent factor for the OS of patients(P<0.05).Conclusions Patients with unexpected SCLC,includingⅠ,Ⅱand partⅢA stage have favorable outcome and can benefit from surgery and systemic postoperative treatment.Standard lobectomy plus systemic lymph node dissection is commended.

关 键 词：肺肿瘤 小细胞肺癌 手术 总生存率 

分 类 号：R734.2[医药卫生—肿瘤]