肺黏液腺癌伴发气道播散的相关因素及预后分析  

Analysis of the related factors and prognosis of mucinous lung adenocarcinoma with spread through air spaces

作　　者：朱永刚[1] 曹磊[2] 田国[3] 王明博[1] 曹峰[4] 田子强[1] ZHU Yonggang;CAO Lei;TIAN Guo;WANG Mingbo;CAO Feng;TIAN Ziqiang(Thoracic Surgery,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China;Department 3 of Geriatrics,Hebei Provincial People's Hospital,Hebei Shijiazhuang 050000,China;Medical Record Room,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China;Department of Radiotherapy,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院胸外科,河北石家庄050011 [2]河北省人民医院老年病三科,河北石家庄050000 [3]河北医科大学第四医院病案室,河北石家庄050011 [4]河北医科大学第四医院放疗科,河北石家庄050011

出　　处：《现代肿瘤医学》2022年第24期4467-4470,共4页Journal of Modern Oncology

基　　金：2022年度河北省医学科学研究课题计划(编号:20221227)。

摘　　要：目的:研究伴有气道播散(spread through air spaces,STAS)的肺黏液腺癌临床病理特征,揭示影响肺黏液腺癌发生STAS的相关因素,分析STAS阳性对肺黏液腺癌患者预后的影响,并探究STAS阳性患者肺组织切除的合理范围。方法:收集2017年3月至2021年9月术后病理确诊的214例肺黏液腺癌患者,根据病理结果是否存在STAS,将其分为STAS阳性组(48例)和STAS阴性组(166例),通过分析患者的临床病理特征来揭示影响肺黏液腺癌发生STAS的因素及STAS阳性对患者生存的影响,并进一步探讨STAS阳性患者肺组织切除范围和生存之间的关系。结果:肺黏液腺癌STAS阳性与肿瘤T分期具有明显相关性,而与患者性别、年龄、吸烟、饮酒、肿瘤家族史、病理TNM分期、肿瘤位置等因素无关。STAS阳性影响患者的术后生存,STAS阳性组患者术后生存劣于STAS阴性组。STAS阳性对患者术后生存的影响与肺组织切除范围有关,行亚肺叶切除患者术后生存STAS阳性组劣于STAS阴性组,而行肺叶切除患者STAS的发生不影响术后生存。结论:肿瘤的大小是影响肺黏液腺癌STAS阳性的重要因素,STAS阳性影响患者的术后生存,STAS阳性患者术后生存受益于足够的切除范围。Objective:To study the clinicopathological characteristics of mucinous lung adenocarcinoma with spread through air spaces(STAS),reveal the related factors affecting the occurrence of STAS in mucino us lung adenocarcinoma,and analyze the impact of positive STAS on the prognosis of patients with mucinous lung adenocarcinoma.The reasonable range of lung tissue resection for STAS positive patients was further explored.Methods:A total of 214 patients with mucinous lung adenocarcinoma diagnosed by pathology after operation from March 2017 to September 2021 were collected and divided into STAS positive group(48 cases)and negative group(166 cases)according to the presence of STAS.The clinicopathological characteristics of patients were analyzed to reveal the factors influencing the occurrence of STAS in mucinous lung adenocarcinoma and the influence of STAS positive on the survival of patients,and to further explore the relationship between the lung tissue resection scope and survival of patients with STAS positive.Results:Positive STAS in mucinous lung adenocarcinoma was significantly correlated with tumor T stage,but not with gender,age,smoking,alcohol consumption,family tumor history,pathological TNM stage,tumor location and other factors.The postoperative survival of patients with positive STAS was affected,and the postoperative survival of patients with positive STAS was worse than that of patients with negative STAS.The effect of positive STAS on postoperative survival was related to the scope of lung tissue resection.The postoperative survival of patients undergoing sublobectomy was worse in the STAS positive group than in the STAS negative group,while the occurrence of STAS in patients undergoing lobectomy did not affect postoperative survival.Conclusion:Tumor size is an important factor affecting STAS positive in mucinous lung adenocarcinoma.STAS positive affects postoperative survival of patients,and STAS positive patients benefit from sufficient resection range.

关 键 词：肺黏液腺癌 气道播散 预后 

分 类 号：R734.2[医药卫生—肿瘤]