腺癌与其他类型非小细胞肺癌术后临床特点的差异及预后因素分析

发布时间：2018-10-09 11:21

【摘要】：背景与目的:近年来肺腺癌已成为肺癌最常见的病理类型,且呈逐年上升的趋势。该研究探讨肺腺癌与其他类型非小细胞肺癌(non-small cell lung cancer,NSCLC)术后临床特点的差异及影响其术后预后的因素。方法:选取广西医科大学附属肿瘤医院2005年1月1日—2014年12月31日经手术治疗的NSCLC患者的病历资料,比较腺癌与其他类型癌临床特点的差异,并运用log-rank方法及Cox比例风险回归模型分析影响腺癌术后预后的因素。结果:451例腺癌患者中,男性与女性比例为1.29∶1,平均发病年龄为56.02岁,淋巴结转移率为53.22%(240/451),中位生存期为44个月;其与其他类型NSCLC在性别比例(P0.001)、平均发病年龄(P=0.039)、淋巴结转移率(P=0.012)和中位生存期(P0.001)方面差异均有统计学意义。多因素分析显示:PTNM分期(P0.001)、性别(P=0.032)、术前合并糖尿病(P=0.019)、隆突下淋巴结转移(P=0.013)、淋巴结转移组数(P0.001)、术后化疗(P=0.040)或靶向治疗(P0.001)是影响腺癌术后预后的独立因素。结论:与其他类型NSCLC相比,腺癌具有女性发病率高、平均发病年龄较低、淋巴结转移率较高和预后较差的特点;PTNM分期、性别、术前合并糖尿病、隆突下淋巴结转移、淋巴结转移组数、术后化疗或靶向治疗是影响其术后预后的重要因素,可为评估预后提供参考。
[Abstract]:Background & objective: in recent years, adenocarcinoma of lung has become the most common pathological type of lung cancer. The purpose of this study was to investigate the difference of postoperative clinical features between adenocarcinoma of lung and other types of non-small cell lung cancer (non-small cell lung cancer,NSCLC) and its prognostic factors. Methods: the medical records of NSCLC patients treated surgically from January 1, 2005 to December 31, 2014 in Cancer Hospital affiliated to Guangxi Medical University were selected to compare the clinical characteristics between adenocarcinoma and other types of cancer. Log-rank method and Cox proportional risk regression model were used to analyze the prognostic factors. Results the ratio of male to female was 1.29: 1, the mean age of onset was 56.02 years old, the lymph node metastasis rate was 53.22% (240 / 451), the median survival time was 44 months. There were significant differences in sex ratio (P0. 001), mean age of onset (P0. 039), lymph node metastasis rate (P0. 012) and median survival (P0. 001). Multivariate analysis showed that the following factors were independent factors affecting the prognosis of adenocarcinoma: P0.001, sex (P0.032), preoperative diabetes mellitus (P0.019), subCarina lymph node metastasis (P0.013), number of lymph node metastases (P0.001), postoperative chemotherapy (P0.040) or targeted therapy (P0.001). Conclusion: compared with other types of NSCLC, adenocarcinoma has the characteristics of higher incidence, lower average age, higher lymph node metastasis rate and worse prognosis, sex, preoperative diabetes mellitus, subtrochanteric lymph node metastasis. The number of lymph node metastases, postoperative chemotherapy or targeted therapy are important factors affecting the prognosis of the patients, which can provide a reference for the evaluation of prognosis.
【作者单位】：广西医科大学附属肿瘤医院胸外科;
【基金】：广西医疗卫生重点科研课题(重200966)
【分类号】：R734.2

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