切换至 "中华医学电子期刊资源库"

中华胸部外科电子杂志 ›› 2015, Vol. 02 ›› Issue (02) : 114 -118. doi: 10.3877/cma.j.issn.2095-8773.2015.02.008

所属专题: 文献

论著

肺腺癌的临床特点及预后分析
杨为贵1,(), 马华玲2   
  1. 1. 430080 湖北省武汉市华润武钢总医院心胸外科
    2. 430080 湖北省武汉市华润武钢总医院病理科
  • 收稿日期:2015-03-20 出版日期:2015-05-28
  • 通信作者: 杨为贵

Clinical characteristics and prognostic analysis of lung adenocarcinoma

Weigui Yang1,(), Hualing Ma2   

  1. 1. Department of Thoracic Cardiovascular Surgery, WISCO General Hospital, Wuhan 430080, China
    2. Department of Pathology, WISCO General Hospital, Wuhan 430080, China
  • Received:2015-03-20 Published:2015-05-28
  • Corresponding author: Weigui Yang
  • About author:
    Corresponding author: Yang Weigui, Email:
引用本文:

杨为贵, 马华玲. 肺腺癌的临床特点及预后分析[J/OL]. 中华胸部外科电子杂志, 2015, 02(02): 114-118.

Weigui Yang, Hualing Ma. Clinical characteristics and prognostic analysis of lung adenocarcinoma[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2015, 02(02): 114-118.

目的

分析手术切除肺腺癌的临床病理特点及预后情况,探讨肺腺癌的预后因素。

方法

回顾性分析接受手术的109例肺腺癌患者的临床资料,将临床病理特点进行单因素分析,单因素分析有统计学意义的指标纳入多因素分析。

结果

109例肺腺癌患者的术后5年生存率为44.0%(48/109),COX回归单因素分析显示肿瘤大小(χ2=8.995,P=0.003)、淋巴结状态(χ2=12.727, P=0.000)、TNM分期(χ2=39.544,P=0.000)、残端有无癌残留(χ2=35.551,P=0.000)、PCNA表达情况(χ2=5.441,P=0.020)影响患者的生存时间。COX回归多因素分析显示肿瘤大小、TNM分期、支气管残端有无癌残留是肺腺癌的独立预后因素(P<0.05);术后辅助化疗是Ⅱ期和Ⅲ期患者的预后影响因素(χ2=11.299,P=0.001)。

结论

肿瘤大小、TNM分期高、外科手术切除不完全是肺腺癌预后差的重要影响因素;Ⅱ期和Ⅲ期患者能够从术后辅助化疗中获益。

Objective

To investigate the clinicopathological characteristics and prognosis of lung adenocarcinoma undergoing resection, and explore the its prognostic factors.

Methods

The clinical data of 109 cases of lung adenocarcinoma undergoing resection were retrospectively reviewed. Univariate analysis of clinicopathological characteristics was performed, and the statistically significant factors were included in multivariate analysis.

Results

For the 109 cases of lung adenocarcinoma, the overall 5-year survival was 44.0%(48/109). Univariate analysis revealed that tumor size(χ2=8.995, P=0.003), lymph node status(χ2=12.727, P=0.0000), TNM stage(χ2=39.544, P=0.000), surgical margin(χ2=35.551, P=0.000)and expression of PCNA(χ2=5.441, P=0.020) influenced survival time. Multivariate analysis indicated that tumor size, TNM stage, and surgical margin were independent prognostic factors of lung adenocarcinoma (P<0.05), and postoperative chemotherapy was prognostic factors of stageⅡ and Ⅲ lung adenocarcinoma(χ2=11.299, P=0.001).

Conclusion

Tumor size, higher TNM stage and positive surgical margin may be important factors of unfavorable prognosis of lung adenocarcinoma, and patients with stage Ⅱ and Ⅲ lung adenocarcinoma may gain benefits from postoperative adjuvant chemotherapy.

图1 109例肺腺癌患者的总生存曲线
表1 109例肺腺癌患者预后因素的单因素分析
图2 接受和未接受术后化疗的Ⅱ+Ⅲ期肺腺癌患者的生存曲线比较
表2 109例肺腺癌Cox模型多因素分析结果
[1]
Bunn Pa Jr. Worldwide overview of the current status of lung cancer diagnosis and treatment [J]. Arch Pathol Lab Med,2012, 136(12):1478-1481.
[2]
Chen WQ, Zheng RS, Zhang SW, et al. The incidences and mortalities of major cancers in China, 2010[J]. Chin J Cancer,2014, 33(8):402-405.
[3]
裴宝祥,孙冰生,张钰,等.集落刺激因子在肺腺癌组织中的表达及其对预后的影响[J].中华肿瘤学杂志,2015,37(2):113-118.
[4]
贾斌,张真发,王长利. 370例肺腺癌各亚型间临床及预后影响因素的比较[J]. 中国肿瘤临床,2009,36(2):61-64.
[5]
Wang Z, Han QB, Gu JL, et al. Clinical significance of gefitinib antitumor activity in patients with lung adenocarcinoma[J]. Oncol Lett,2015, 9(1):257-261.
[6]
Xu S, Xi J, Jiang W, et al. Solid component and tumor size correlate with prognosis of stage ⅠB lung adenocarcinoma[J].Ann Thorac Surg,2015, 99(3):961-967.
[7]
Kinoshita T, Ohtsuka T, Hato T, et al. Prognostic factors based on clinicopathological data among the patients with resected peripheral squamous cell carcinomas of the lung[J]. J Thorac Oncol, 2014, 9(12):1779-1787.
[8]
Wang CL, Li Y, Yue DS, et al. Value of the metastatic lymph node ratio for predicting the prognosis of non-small-cell lung cancer patients[J].World J Surg, 2012,36(2):455-462.
[9]
Ramón R, Christian W, Peter G. Complete resection in lung cancer surgery: proposed definition[J]. Lung Cancer, 2005, 49(1):25-33.
[10]
Liu W, Wu Y, Wang L, et al. Protein signature for non-small cell lung cancer prognosis[J].Am J Cancer Res,2014,4(3):256-269.
[11]
Pitz MW, Musto G, Navaratnam S. Sex as an independent prognostic factor in a population-based, non-small cell lung cancer cohort[J]. Can Respir J,2013,20(1):30-34.
[12]
Suehisa H, Toyooka S. Adjuvant chemotherapy for completely resected non-small-cell lung cancer[J]. Acta Med Okayama,2009,63(5):223-230.
[13]
Padda SK, Burt BM, Trakul N, et al. Early-stage non-small cell lung cancer: surgery, stereotactic radiosurgery, and individualized adjuvant therapy[J].Semin Oncol,2014,41(1):40-56.
[14]
Sun Y, Yu X, Shi X, et al. Correlation of survival and EGFR mutation with predominant histologic subtype according to the new lung adenocarcinoma classification in stage IB patients[J].World J Surg Oncol,2014,12:148.
[1] 张晓宇, 殷雨来, 张银旭. 阿帕替尼联合新辅助化疗对三阴性乳腺癌的疗效及预后分析[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 346-352.
[2] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[3] 高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[4] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[5] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[6] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[7] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[8] 顾雯, 凌守鑫, 唐海利, 甘雪梅. 两种不同手术入路在甲状腺乳头状癌患者开放性根治性术中的应用比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 687-690.
[9] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[10] 李伟, 宋子健, 赖衍成, 周睿, 吴涵, 邓龙昕, 陈锐. 人工智能应用于前列腺癌患者预后预测的研究现状及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 541-546.
[11] 陈樽, 王平, 金华, 周美玲, 李青青, 黄永刚. 肌肉减少症预测结直肠癌术后切口疝发生的应用研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 639-644.
[12] 韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[13] 董佳, 王坤, 张莉. 预后营养指数结合免疫球蛋白、血糖及甲胎蛋白对HBV 相关慢加急性肝衰竭患者治疗后预后不良的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 555-559.
[14] 刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[15] 王景明, 王磊, 许小多, 邢文强, 张兆岩, 黄伟敏. 腰椎椎旁肌的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 846-852.
阅读次数
全文


摘要