【摘要】 目的分析术后病理Ⅰ_A期非小细胞肺癌患者的临床病理特征,探讨影响其预后的危险因素。方法回顾性分析我科1993年1月至2012年12月术后病理证实为Ⅰ_A期的非小细胞肺癌患者138例的临床资料,其中男81例、女57例,年龄37~80岁,中位年龄61岁。收集相关住院临床资料和随访资料。绘制Kaplan-Meier生存曲线,采用Cox比例风险模型进行单因素和多因素分析,评价各因素对无病生存的影响。结果随访时间9~90个月,中位随访时间为59个月。随访过程中患者出现复发转移14例(10.1%),局部复发8例,同时发现骨转移和同侧肺门淋巴结增大1例。单因素分析显示脉管浸润(P=0.017)、病理低分化(P=0.043)、肿瘤直径≥2 cm(T1b,P=0.017)是预后不良的危险因素。多因素分析表明脉管侵犯(P=0.011)和肿瘤的直径≥2 cm(T1b,P=0.026)是Ⅰ_A期非小细胞肺癌患者预后不良的独立危险因素。结论脉管浸润和肿瘤直径是Ⅰ_A期非小细胞肺癌患者预后的独立危险因素。更多还原

【Abstract】 Objective To identify prognostic factors for patients with non-small cell lung cancer(NSCLC) in pathologic stage Ⅰ_A after operation. Methods We retrospectively analyzed the clinical data of 138 patients, who underwent surgical resection at our institution for stage Ⅰ_A NSCLC. There were 81 males and 57 females with a median age of 61 years(ranged from 37 to 80 years). The in-hospital data and follow-up results were collected. Survival curve was generated by Kaplan-Meier method. Univariate and multivariate analyses of disease-free survival(DFS) were performed. Results The follow-up time was from 9 to 90 months with a median of 59 months. During the follow-up, recurrence and metastasis occurred in 14 patients, local relapse in 8 patients, bone and ipsilateral lymph node metastasis occurred in one patient.Univariate analysis showed that DFS of patients was related with blood vessel or lymphatic invasion(P=0.017), poor histological differentiation(P=0.043), and tumor diameter ≥ 2 cm(P=0.017), respectively. Multivariate analysis demonstrated that tumor diameter ≥ 2 cm(P=0.026) and blood vessel or lymphatic invasion(P=0.011) were independent prognostic factors for DFS of stage Ⅰ_A NSCLC patients after operation. Conclusion Our analyses indicate vessel involvement and the tumor diameter are independent indicators of DFS in patients with pathologic stage Ⅰ_A NSCLC after operation.更多还原