ⅠA期非小细胞肺癌患者微创切除术后复发的危险因素  

Risk Factors for Recurrence After Minimally Invasive Resection in Patients with StageⅠA Non-small Cell Lung Cancer

作　　者：李志伟[1] 杨龙 宋伟康 卢华伟 李荣耀 LI Zhiwei;YANG Long;SONG Weikang;LU Huawei;LI Rongyao(General Thoracic Surgery Department,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院普胸外科,河南周口466000

出　　处：《河南医学研究》2025年第1期65-68,共4页Henan Medical Research

摘　　要：目的探讨ⅠA期非小细胞肺癌患者微创切除术后复发的危险因素。方法回顾性分析2019年1月至2020年6月周口市中心医院收治186例ⅠA期非小细胞肺癌患者的临床资料,根据随访期间有无复发将其分为复发组(54例)和无复发组(132例)。比较两组随访、复发情况及临床资料,并采用多因素logistic回归分析法分析ⅠA期非小细胞肺癌患者微创切除术后复发的危险因素。结果所有患者在出院后均接受随访,随访时间为5~30个月,随访期间复发率为29.03%,其中同侧肺部复发占11.83%,同侧胸膜复发占2.15%,纵隔淋巴结复发占8.06%,残端合并气管复发占1.08%,气管残端复发占5.91%。复发组年龄≥60岁、病灶直径≥3 cm、低分化、切除支气管残端阳性、术前血清癌胚抗原(CEA)水平≥2.5μg·L^(-1)、术前全血中性粒细胞与淋巴细胞比值(NLR)≥2.5的患者占比高于无复发组(P<0.05)。多因素logistic回归分析结果显示,病灶直径≥3 cm、低分化、切除支气管残端阳性、术前血清CEA水平≥2.5μg·L^(-1)、术前全血NLR≥2.5是ⅠA期非小细胞肺癌患者微创切除术后复发的独立危险因素(OR=2.455、3.364、2.155、3.397、1.545,P<0.05)。结论ⅠA期非小细胞肺癌患者微创切除术后复发的风险较高,病灶直径≥3 cm、低分化、切除支气管残端阳性、术前血清CEA水平≥2.5μg·L^(-1)、术前全血NLR≥2.5是ⅠA期非小细胞肺癌患者微创切除术后复发的独立危险因素,临床可据此给予相应的治疗及干预措施,以减少术后复发。Objective To explore the risk factors for recurrence after minimally invasive resection in patients with stageⅠA non-small cell lung cancer.Methods The clinical data of 186 patients with stageⅠA non-small cell lung cancer admitted to Zhoukou Central Hospital from January 2019 to June 2020 were retrospectively analyzed.The selected patients were divided into the recurrence group(54 cases)and the non recurrence group(132 cases)according to whether there was recurrence during the follow-up period.The follow-up,recurrence status,and clinical data between two groups were compared,and the risk factors for recurrence in stageⅠA non-small cell lung cancer patients after minimally invasive resection was analyzed by multivariate logistic regression analysis.Results All patients were followed up for 5-30 months after discharge,the rate of recurrence was 29.03%,including ipilateral lung recurrence(11.83%),ipilateral pleura recurrence(2.15%),mediastinal lymph node recurrence(8.06%),stump combined with tracheal recurrence(1.08%),and tracheal stump recurrence(5.91%).The proportion of patients with age≥60 years,lesion diameter≥3 cm,low differentiation,positive bronchial stump,the level of preoperative serum carcinoembryonic antigen(CEA)≥2.5μg·L^(-1)and preoperative whole blood neutrophil to lymphocyte ratio(NLR)≥2.5 in the recurrence group were higher than those of the non-recurrence group(P<0.05).The results of multivariate logistic regression analysis showed that lesion diameter≥3 cm,low differentiation,positive bronchial stump resection,the level of preoperative serum CEA≥2.5μg·L^(-1),and the level of preoperative whole blood NLR≥2.5 were independent risk factors for recurrence in patients with stageⅠA non-small cell lung cancer after minimally invasive resection(OR=2.455,3.364,2.155,3.397,1.545;P<0.05).Conclusion Patients with stageⅠA non-small cell lung cancer had a higher risk of recurrence after minimally invasive resection.Lesion diameter≥3 cm,low differentiation,positive resection of bronch

关 键 词：非小细胞肺癌 ⅠA期 复发 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]