非小细胞肺癌与脉管癌栓的相关性及对手术后预后的影响  

Correlation Analysis of Vascular Tumor Thrombi in Non-small Cell Lung Cancer and Its Effect on Postoperative Prognosis

作　　者：王倩[1] 张敏 冯晓宇 WANG Qian;ZHANG Min;FENG Xiaoyu(Puyang Oilfield General Hospital,Puyang,457001)

机构地区：[1]河南省濮阳市油田总医院,457001

出　　处：《实用癌症杂志》2023年第1期148-151,共4页The Practical Journal of Cancer

摘　　要：目的 探讨脉管癌栓与非小细胞肺癌(NSCLC)的关系及其对患者手术后预后的影响。方法 回顾性分析189例NSCLC患者的临床资料,按临床结局将其分为生存组(n=125)与死亡组(n=64),运用多因素Logistic回归分析模型分析手术后预后的影响因素;同时依据患者是否有脉管癌栓将其划分成有脉管癌栓组(n=58)与无脉管癌栓组(n=131),统计2组3年生存率。结果 单因素分析显示:年龄、性别、病理分型、体重指数(BMI)与NSCLC患者手术后的预后无关,差异无统计学意义(P>0.05);临床分期、肿瘤直径、淋巴结转移、脉管癌栓、术后化疗与NSCLC患者手术后的预后有关,差异有统计学意义(P<0.05);多因素Logistic回归分析显示:临床Ⅲ+Ⅳ期、肿瘤直径>5 cm、有淋巴结转移、有脉管癌栓、术后未行化疗为NSCLC患者手术后预后的主要影响因素(P<0.05)。Kaplan-Meier结果显示:有脉管癌栓组的3年生存率[37.93%(22/58)]低于无脉管癌栓组[78.63%(103/131)],差异有统计学意义(P<0.05)。结论影响NSCLC患者手术后预后的因素较多,包括临床Ⅲ+Ⅳ期、肿瘤直径>5 cm、淋巴结转移、脉管癌栓、术后未行化疗等,且有脉管癌栓的患者3年生存率更低,手术后预后更差。Objective To investigate the relationship between vascular tumor thrombus and non-small cell lung cancer(NSCLC) and its impact on the prognosis of patients after surgery.Methods Clinical data of 189 patients with NSCLC were retrospectively analyzed.According to the clinical outcome, they were divided into survival group(n=125) and death group(n=64).The influencing factors of postoperative prognosis were analyzed by multivariate logistic regression analysis model;At the same time, the patients were divided into 2 groups according to whether they had vascular tumor thrombus(n=58) and no vascular tumor thrombus(n=131).The 3-year survival rates of the 2 groups were counted.Results univariate analysis showed that age, sex, pathological type and body mass index(BMI) had no relationship with the prognosis of NSCLC patients after operation, and the difference was not statistically significant(P>0.05);Clinical stage, tumor diameter, lymph node metastasis, vascular tumor thrombus and postoperative chemotherapy were significantly related to the prognosis of NSCLC patients(P<0.05);Multivariate logistic regression analysis showed that clinical stage Ⅲ+Ⅳ(β=1.799,or=6.045,95%ci=3.127~11.687),tumor diameter >5 cm(β=2.178,or=8.829,95%ci=4.350~17.921),with lymph node metastasis(β=2.311,or=10.088,95%ci=4.894~20.795),with vascular tumor thrombus(β=3.956,or=52.232,95%ci=20.616~132.335),no chemotherapy after operation(β=1.965,or=7.135,95%ci=3.601~14.138) were the main influencing factors of postoperative prognosis in patients with NSCLC(P<0.05);Kaplan Meier results showed that the 3-year survival rate of the group with vascular tumor thrombus [34.48%(20/58)] was lower than that of the group without vascular tumor thrombus [53.44%(70/131)],and the difference was statistically significant(P<0.05).Conclusion There are many factors influencing the postoperative prognosis of NSCLC patients, including clinical stage Ⅲ+Ⅳ,tumor diameter >5 cm, lymph node metastasis, vascular tumor thrombus, and no postoperative chemotherapy.The 3

关 键 词：非小细胞肺癌 脉管癌栓 预后 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]