pN0非小细胞肺癌术前淋巴结肿大的预后意义  

The prognostic significance of preoperative lymphadenopathy in pNO non-small cell lung cancer

作　　者：房昕 郑松[1,2] Fang Xin

机构地区：[1]杭州市肿瘤医院,310000 [2]浙江大学医学院附属杭州市第一人民医院,310000 [3]哈尔滨医科大学附属肿瘤医院,150081

出　　处：《浙江临床医学》2022年第12期1752-1754,1758,共4页Zhejiang Clinical Medical Journal

摘　　要：目的探讨pN0非小细胞肺癌患者术前影像学中提示肺门纵隔淋巴结单发或多发对患者预后的影响及其相关危险因素.方法回顾性分析2011年1月至2014年12月在哈尔滨医科大学附属肿瘤医院确诊为pN0期非小细胞肺癌(NSCLC)的患者403例,根据影像学显示肺门纵隔淋巴结情况将患者分为单发组(n=297)和多发组(n=106),Logistic回归分析方法对淋巴结肿大情况的危险因素进行分析.同时,Kaplan-Meier法分析淋巴结单发和多发对pN0期肺癌患者预后的差异.结果淋巴结多发组无病生存期(DFS)及总生存期(OS)明显高于单发组.肿瘤位置、白细胞计数和ALP浓度是患者单发淋巴结肿大的危险因素,也是患者不良预后的因素.结论pN0非小细胞肺癌患者术前影像学提示淋巴结肿大是影响DFS预后的独立危险因素,并且淋巴结单发组较多发组预后更差.Objective To investigate the effect of single or multiple lymph nodes on the prognosis of patients with pNO stage non-small cell lung cancer and the related risk factors.MethodsA retrospective analysis of 403 patients with pNO non-small cell lung cancer(NSCLC)diagnosed in the Cancer Hospital Afiliated to Harbin Medical University from January 2011 to December 2014.Patients were divided into two groups according to whether the lymph nodes were single or muliple,with 297 cases in the single group and 106 cases in the multiple group.Non-conditional Logistic regresion single factor and multivariate analysis were used to identify the risk factors of lymph adenomegaly in patients with pNO phase.Kaplan-Meier was used to compare the prognosis of single and multiple lymph nodes in lung cancer patients.Results Disease-free survival(DFS)and overall survival(OS)in pNO stage patients with multiple lymph nodes group were significantly higher than those in single lymph node group.Both of median OS and DFS of patients with single lymph node were higher than multiple lymph nodes.Tumor location,white blood cell(WBC)counts,and ALP were risk factors for single lymph node enlargement in patients and were also factors which were contributed to the poor prognosis of patients.Conclusion Preoperative imaging suggests that lymphadenopathy is an independent risk factor for the prognosis of DFS in patients diagnosed with pNO NSCLC.The prognosis of single lymph node group is worse than in multiple lymph nodes.

关 键 词：非小细胞肺癌 淋巴结肿大 危险因素 预后 

分 类 号：R734.2[医药卫生—肿瘤]