吉林大学学报(医学版)

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脏层胸膜浸润对术后早期非小细胞肺癌患者预后的影响

张慧1，邵国光2，闫旭3，孙宏伟1，王星星1，邵铭心1，马克威1   

  1. 1. 吉林大学第一医院肿瘤中心，吉林 长春 130021；2. 吉林大学第一医院胸外科，吉林 长春 130021；3. 吉林大学第一医院病理科，吉林 长春 130021
  • 收稿日期:2013-11-04 出版日期:2014-03-28 发布日期:2014-05-28
  • 通讯作者: 马克威 （Tel:0431-88782720，E-mail：makw@jlu.edu.cn） E-mail:makw@jlu.edu.cn
  • 作者简介:张 慧（1985-），女，辽宁省营口市人，在读医学硕士，主要从事肿瘤的分子靶向治疗研究。
  • 基金资助:

    国家自然科学基金资助课题（81372870）

Influence of visceral pleural invasion on prognosis of patients with early  non-small cell lung cancer after operation

ZHANG Hui1,SHAO Guo-guang2,YAN Xu3,SUN Hong-wei1,WANG Xing-xing1,SHAO Ming-xin1,MA Ke-wei1   

  1. 1.Tumor Center,First Hospital,Jilin University,Changchun 130021,China; 2.Department of Thoracic Surgery,First Hospital,Jilin University,Changchun 130021,China;3.Department of Pathology,First Hospital,Jilin University,Changchun 130021,China
  • Received:2013-11-04 Online:2014-03-28 Published:2014-05-28

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摘要：

目的：研究术后早期非小细胞肺癌（NSCLC）患者的脏层胸膜浸润（VPI）情况，阐明VPI对NSCLC患者预后的影响。方法：门诊随访2007—2011年本院经外科根治性术后病理分期为Ⅰ～Ⅱ期NSCLC患者261例，中位随访时间36个月，将患者分为VPI组(130例)和无VPI组(131例)，采用χ2检验或Fisher精确概率法进行分类变量分析；Kaplan-Meier法估算患者无疾病生存率和总生存率，采用COX比例风险模型分析患者临床特征与预后的关系。结果：VPI组患者1年总生存率为90.77%，无VPI组患者1年总生存率为93.13%，组间比较差异无统计学意义（P>0.05）。VPI组患者3和5年总生存率（69.23%和63.85%）低于无VPI组（80.15%和74.05%）（P<0.05）。COX单因素及多因素分析，年龄、肿瘤大小和VPI是影响NSCLC患者无疾病生存期(DFS)和总生存期(OS)的独立预后因素（P<0.05）。 结论：VPI是术后早期NSCLC患者不良预后因素之一,对肿瘤临床病理分期标准有影响。

关键词:  , 癌, 非小细胞肺, 脏层胸膜浸润, 预后, 总生存期, 无疾病生存期

Abstract:

Objective
To study the visceral pleural invasion （VPI） situation of  the patients with early postoperative non-small cell lung cancer （NSCLC）,and to clarify its influence in prognosis of NSCLC patients. Methods 261 NSCLC patients were  followed up in outpatient department  who were diagnosed as the pathologic stage Ⅰ－Ⅱ after surgical radical operation from 2007 to 2011.The median follow-up time was 36 months.All the patients were divided into VPI group(n=130) and non-VPI group(n=131).χ2 test or Fisher  exact test was used to analyze the categorical variables;Kaplan-Meier method was used to estimate the disease-free survival（DFS） rate  and overall survival（OS） rate;COX proprotional hazards model was used to analyze the relationship between the clinical characteristic and prognosis of NSCLC patients.Results The  1-year OS rate  of the patients in VPI group was 90.77%,meanwhile it was 93.13% in non-VPI group,there was no significant difference between  two groups（P>0.05）. The 3-year and 5-year OS rates (69.23% and 63.85%) of the patients in VPI group were lower  than those in non-VPI group (80.15% and 74.05%)(P<0.05).COX unuvariate and multivariate analysis indicated that age,tumor size,and VPI  were the influnencing factors of  DFS and OS of the NSCLC patients (P<0.05).Conclusion VPI is one of the poor prognostic factors of early postoperative NSCLC patients,and it plays an  role in criteria of tumor clinicopathological  stage.

Key words: cancer,non-small cell lung, visceral pleural invasion, prognosis, overall survival, disease-free survival

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