非小细胞肺癌手术治疗的预后因素分析  

Analysis of Prognostic Factors in Resection of Non-Small Cell Lung Cancer

作　　者：姜宏景[1] 王长利[1] 

机构地区：[1]天津医科大学附属肿瘤医院胸科,300060

出　　处：《天津医药》2003年第5期282-284,共3页Tianjin Medical Journal

摘　　要：目的 :探讨非小细胞肺癌的预后影响因素。方法 :分析行根治性切除的非小细胞肺癌477例 ,采用Ka plan Meier法绘制生存曲线(Log Rank检验)和Cox多因素回归对该组病例的预后因素进行分析。结果 :肿瘤的N分期明显影响患者的预后 ,无肺门及纵隔淋巴结转移病人的生存率明显高于有转移的病人(P<0 001) ;术中同侧肺门和纵隔淋巴结清扫超过6枚的病例生存率高于清扫6枚以下的病例(P<0 001) ;术后生存率随T1、T2、T3和T4依次明显递减(P<0 001) ;术后化疗组病例的生存期较非化疗组长(P=0 036) ;鳞癌和腺癌的生存率高于其他病理类型(P=0.001)。结论 :纵隔淋巴结的清扫数量、术后化疗与否、肿瘤的T分期、N分期和病理类型是影响非小细胞肺癌手术患者预后的主要因素 ,而性别、术后放疗、术后免疫治疗及手术方式等对预后无明显影响。Objective:To analyse the prognostic factors in the resection of nonˉsmall cell lung cancer.Methˉods:Using Kaplanˉmeier survival curve and Cox regression model,the prognostic factors in the resection of477patients with nonˉsmall cell lung cancer were analyzed.Results:The patients with N0had a longer survival peˉriod than those with N1or N2(P<0.001).The patients who were resected more than6lymph nodes in the ipsilateral hilum and mediastina during operation had a higher survival rate than those who were resected less than6lymph nodes(P<0.001).From Tl to T4,the survival rates gradually decreased(P<0.001).The patients who received a postoperative chemotherapy had a longer survival period than those who did not(P=0.036).The patients with squamous carcinoma and adenocarcinoma had a better survival rates than those with other cancer(P<0.001).Conclusion:The number of resected lymph nodes,T stage,N stage,postoperative chemotherapy and pathologic type are the main prognostic factors,while other factors,such as the sex,postoperative radioˉtherapy,postoperative immunotherapy and operation program had no significant effect on the prognosis.

关 键 词：非小细胞肺癌 手术治疗 预后 影响因素 纵隔淋巴结转移 

分 类 号：R734.2[医药卫生—肿瘤]