非小细胞肺癌患者微创切除术后的复发与转移状况研究

发布时间：2018-07-12 20:20

本文选题：胸腔镜 + 非小细胞肺癌　；参考：《中国内镜杂志》2017年09期

【摘要】：目的分析非小细胞肺癌(NSCLC)患者微创切除术后的复发与转移状况。方法选取2008年1月-2013年12月该院行胸腔镜下肺叶切除术的123例NSCLC患者为研究对象,统计其围手术期资料和随访结果,记录术后复发与转移情况,采用多因素Logistic回归分析术后复发与转移的影响因素。结果全部患者的中位手术时间为165 min(60~430 min),中位术中出血量95 ml(20~3 100 ml),术后共出现15例(12.2%)并发症。全部患者出院后均进行定期随访,中位随访时间为23.5个月(6~69个月),随访期间分别有36例(29.3%)患者出现复发,42例(34.1%)患者出现转移;其中,有16例(13.0%)患者同时出现复发与转移。同侧肺部(52.8%)是最常见的复发部位,其次是纵隔淋巴结(38.9%),骨(28.6%)是最常见的转移部位,其次是对侧肺部(26.2%)、脑部(19.0%)。多因素Logistic回归分析结果表明,Ⅱ~Ⅲ期、纵隔淋巴结转移、低分化是患者出现术后复发的独立危险因素(P0.05),Ⅱ~Ⅲ期、淋巴结转移数目≥3个、术后无放化疗是患者出现术后转移的独立危险因素(P0.05)。结论对NSCLC患者而言,胸腔镜下肺叶切除手术的术后复发、转移主要发生在同侧肺部与骨,TNM分期、纵隔淋巴结转移、分化程度、淋巴结转移数目、术后放化疗与术后复发和转移有关。
[Abstract]:Objective to analyze the recurrence and metastasis status of non small cell lung cancer (NSCLC) patients after minimally invasive resection. Methods 123 patients with NSCLC in January 2008 -2013 year December were studied by thoracoscopic lobectomy, the perioperative data and follow-up results were statistically analyzed, and the recurrence and metastasis were recorded after the operation, and multiple factor Logistic cycles were used. The median operative time of all patients was 165 min (60~430 min), the amount of hemorrhage was 95 ml (20~3 100 ml) during the middle operation and 15 cases (12.2%) after the operation. All the patients were followed up regularly after discharge, and the median follow-up time was 23.5 months (6~69 months), and 36 cases were followed up during the follow-up period. 29.3%) recurrence and metastasis in 42 cases (34.1%); of which 16 cases (13%) had recurrence and metastasis. The same lateral lung (52.8%) was the most common recurrence site, followed by mediastinal lymph node (38.9%), bone (28.6%) was the most common metastatic site, followed by contralateral lung (26.2%), and the brain (19%). Multiple factor Logistic regression. The results showed that stage II ~ III, mediastinal lymph node metastasis and low differentiation were independent risk factors (P0.05) for postoperative recurrence. The number of lymph node metastases in stage II ~ III was more than 3, and no radiotherapy after operation was an independent risk factor for postoperative metastasis (P0.05). Conclusion for NSCLC patients, the postoperative recovery of thoracoscopic lobectomy The metastasis mainly occurred in the same side of the lung and bone, TNM staging, mediastinal lymph node metastasis, the degree of differentiation, the number of lymph node metastases, and postoperative radiotherapy and chemotherapy related to postoperative recurrence and metastasis.
【作者单位】：贵州省人民医院胸外科;
【分类号】：R734.2

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