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中华胸部外科电子杂志 ›› 2016, Vol. 03 ›› Issue (04) : 193 -198. doi: 10.3877/cma.j.issn.2095-8773.2016.04.01

所属专题: 文献

论著

老年多发磨玻璃结节的外科治疗策略及疗效分析
武韫1, 吕帆真1, 沈晓咏1, 朱正洪1, 高文1,()   
  1. 1. 200040 上海,复旦大学附属华东医院胸外科
  • 收稿日期:2016-09-20 出版日期:2016-11-28
  • 通信作者: 高文

Surgical management and outcomes of multifocal ground-glass opacities in elderly patients

Yun Wu1, Fanzheng Luy1, Xiaoyong Shen1, Zhenghong Zhu1, Wen Gao1,()   

  1. 1. Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai 200040, China
  • Received:2016-09-20 Published:2016-11-28
  • Corresponding author: Wen Gao
  • About author:
    Corresponding author:Gao Wen, E-mail:
引用本文:

武韫, 吕帆真, 沈晓咏, 朱正洪, 高文. 老年多发磨玻璃结节的外科治疗策略及疗效分析[J/OL]. 中华胸部外科电子杂志, 2016, 03(04): 193-198.

Yun Wu, Fanzheng Luy, Xiaoyong Shen, Zhenghong Zhu, Wen Gao. Surgical management and outcomes of multifocal ground-glass opacities in elderly patients[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2016, 03(04): 193-198.

目的

探讨老年多发磨玻璃结节(GGO)的外科治疗策略及疗效。

方法

回顾性分析2011年1月至2013年1月于复旦大学附属华东医院胸外科收治的78例老年多发GGO患者,根据术前影像学中磨玻璃结节实质部分比例,分为磨玻璃结节(GGO)组34例(C/T<0.5)和实质结节(SN)组44例(C/T>0.5),比较不同手术方式对两组患者总生存率的影响,并分析影响预后的因素。

结果

亚肺叶切除组(37例)3年总生存率为87.3%,肺叶切除组(33例)为85.6%,两组间差异无统计学意义(χ2=1.285,P>0.05);GGO组术后3年总生存率为97.1%,SN组为79.5%,GGO总生存率显著高于SN组(χ2=8.490,P<0.05);T1a组3年总生存率为95.3%,T1b为77.1%,T1a组总生存率显著高于T1b组(χ2=8.490,P<0.05)。术后预后多因素分析提示,结节直径(T)和C/T比与预后密切相关(P<0.05)。

结论

老年多发磨玻璃患者的亚肺叶切除具有与肺叶切除相似的治疗效果,结节直径和C/T比是影响预后的因素。

Objective

To discuss the surgical management and outcomes of multifocal ground-glass opacities (GGO) in elderly patients.

Methods

The clinical data of 78 elderly patients with multifocal GGO treated in Department of Thoracic Surgery, Huadong Hospital affiliated to Fudan University between January 2011 and January 2013 were retrospectively analyzed. According to the consolidation proportion on preoperative imaging findings, 34 patients were classified into GGO group (GGO-dominant lesion, C/T≤0.5), and 44 in SN-group (solid-dominant lesion, C/T>0.5). The effects of different surgical procedures on survival of patients in two groups were compared, and the factors related to outcomes were analyzed.

Results

The 3-year survival in sublobar resection group (n=37) was 87.3%, which was not significantly different from that in standard lobectomy group (n=33, 85.6%)(χ2=1.285, P>0.05). The 3-year survival in GGO group was significantly higher than that in SN group (97.1% vs 79.5%, χ2=8.490, P<0.05). The 3-year survival in T1a group was significantly higher than that in T1b group(95.3% vs 77.1%, χ2=0.660, P<0.05). Multivariate analysis demonstrated that nodular diameter and C/T ratio were closely related to prognosis (P<0.05).

Conclusions

Sublobar resection for multifocal GGO is considered to be an appropriate treatment in the elderly patients as this procedure provides an equivalent long-term outcome in comparison with lobectomy. The nodular diameter and C/T ratio are associated with prognosis.

表1 磨玻璃结节(GGO)组和实质性结节(SN)患者一般资料比较
表2 78例老年磨玻璃结节(GGO)患者的手术资料
表3 磨玻璃结节(GGO)组和实质性结节(SN)患者术后病理资料比较
图1 A:磨玻璃结节(GGO)组和实质性结节(SN)组3年总生存率比较;B:T1a组和T1b组3年总生存率比较
表4 78例老年多发磨玻璃结节(GGO)患者的预后影响因素分析
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