气腔播散与早期肺腺癌临床病理关系及对患者预后的影响  

Clinicopathological Relationship Between Air Cavity Dissemination and Early Lung Adenocarcinoma and Its Influence on the Prognosis of Patients

作　　者：韩高扬 李小丽[2] 韩玉杰 张仁锋 魏创业 孔晓煌 连欢欢 王金龙 HAN Gaoyang;LI Xiaoli;HAN Yujie;ZHANG Renfeng;WEI Chuangye;KONG Xiaohuang;LIAN Huanhuan;WANG Jinlong(Department of Thoracic Surgery,Zhengzhou Central Hospital Affiliated of Zhengzhou University,Zhengzhou 450007,China;Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院胸外科,河南郑州450007 [2]郑州大学第一附属医院肿瘤科,河南郑州450000

出　　处：《河南医学研究》2023年第11期1921-1927,共7页Henan Medical Research

基　　金：河南省医学科技攻关计划(联合共建)基金资助项目(LHGJ20190014)。

摘　　要：目的研究气腔播散(STAS)的程度与早期肺腺癌(≤3 cm)间的临床病理特征及与患者预后的关系。方法对2014—2016年在郑州大学附属郑州中心医院行手术切除的348例早期肺腺癌患者进行STAS分级,并分析与临床病理间的关系及对患者预后的影响。结果348例早期肺腺癌患者中STAS 0级为181例、STASⅠ级为97例、STASⅡ级为70例。其中STAS的发生和分级程度在胸膜侵犯、血管侵犯、淋巴管侵犯、肿瘤坏死之间差异有统计学意义(P<0.05)。随着STAS分级的升高,患者无复发生存期(RFS)和总生存期(OS)降低,且STASⅡ级与STAS 0级和STASⅠ级间差异有统计学意义(P<0.05),但STASⅠ级和STAS 0级间差异无统计学意义(P>0.05),此外STASⅡ级是亚肺叶切除和肺叶切除独立的预后不良因素(P<0.05)。结论早期肺腺癌患者中大约20.1%是STASⅡ级,且STASⅡ级是肺腺癌独立的不良预后因素。Objective To study the relationship between the degree of spread through air space(STAS)and the clinicopathologic characteristics of early lung adenocarcinoma(≤3 cm)and its influence on the prognosis of patients.Methods A total of 348 patients with early lung adenocarcinoma who underwent surgical resection in Zhengzhou Central Hospital Affiliated of Zhengzhou University from 2014 to 2016 were graded by STAS,and the relationship with clinicopathology and the impact on the prognosis of patients were analyzed.Results Of the 348 patients with early lung adenocarcinoma,181 patients were of STAS grade 0,97 patients were of STAS gradeⅠand 70 patients were of STAS gradeⅡ.There were differences in the incidence and degree of STAS in pleural invasion,vascular invasion,lymphatic invasion and tumor necrosis(P<0.05).With the increase of STAS grade,the relapse free survival(RFS)and total survival(OS)of the patients decreased,and there was statistical significance between STASⅡand STAS 0 and STASⅠ(P<0.05),but there was no statistical significance between STAS I and STAS 0(P>0.05).In addition,STASⅡwas a poor prognostic factor for sub-lobectomy and lobectomy alone(P<0.05).Conclusion About 20.1%of patients with early lung adenocarcinoma are STASⅡ,and STASⅡis an independent adverse prognostic factor.

关 键 词：肺腺癌 气腔播散 预后 

分 类 号：R655.3[医药卫生—外科学]