【摘要】 目的评估非小细胞肺癌根治性切除术后转移规律与预后之间的相关性。方法回顾性分析2005年1月至2011年12月于我院胸外科行根治性肺叶切除的非小细胞肺癌患者94例的临床资料,分析术后转移规律与预后之间的关系。男53例、女41例,年龄62(57~76)岁。结果全组两年以后发生转移者占52.12%(49/94),90.43%(85/94)患者发生单系统转移。最常见的术后转移部位为肺组织(38/94,40.42%)、骨转移(27/94,28.72%)、脑转移(24/94,25.53%)。随访终点94例入组患者总生存率为41.5%。单系统转移患者和多系统转移患者的生存率分别为45.9%和0.0%(P<0.001)。两年内发生单系统转移患者和转移时间超过两年患者组的总生存率分别为53.3%和30.6%(Cox P=0.130,Breslow P=0.014)。Cox回归对与生存率相关因素进行分析,结果显示TNM分期为Ⅰ~Ⅱ期(P=0.003)以及单系统转移(P<0.001)与生存率呈正相关。结论非小细胞肺癌根治性切除术后容易发生肺组织、骨骼以及脑转移,术后发生多系统转移的患者预后较差。更多还原

【Abstract】 Objective To evaluate the prognostic significance of postoperative metastasis in non-small cell lung cancer(NSCLC).Methods We retrospectively analyzed the clinical data of 94 patients who underwent curative lobectomy and pathologically diagnosed with NSCLC in our hospital between January 2005 and December 2011.There were 53 males and 41 females with a mean age of 62(57-76) years.Results Among 94 patients,metastasis occurred during late stage(more than 2 years postoperatively) in 49(52.12%) patients.Single organ metastasis and multiple organ metastasis were found in 85(90.43%) patients.The most popular metastatic site was lung(38/94,40.42%),and then bone(27/94,28.72%),and brain(24/94,25.53%).The overall survival(OS) rate of all included patients was 41.5%.The median survival time was 43 months and 29 months for the single metastasis and multiple metastasis groups respectively.There was a statistical difference in OS rate between the single metastasis and multiple metastasis groups(45.9%vs.0.0%,P<0.001).The median survival time was 50 months and 32 months for early metastatic patients and late metastatic patients respectively.Statistical difference was found in OS rate between the single metastasis and multiple metastasis groups(53.3%vs.30.6%,Cox P=0.130,Breslow P=0.014).Cox regression showed TNM stage(P=0.003) and single organ metastasis(P<0.001) were significant prognostic factors for NSCLC.Conclusion Lung,bone,and brain were the most popular metastatic organs for postoperative NSCLC.The presence of multiple organ metastases can be identified as an independent poor prognostic factor in NSCLC.更多还原