Ⅲ<sub>A</sub> (N<sub>2</sub>)期NSCLC术后预后因素分析

doi:10.3760/cma.j.issn.1004-4221.2016.10.007

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摘要目的研究Ⅲ_A (N₂)期NSCLC患者术后转移、复发及生存的相关因素，为患者术后选择放疗提供客观依据。方法收集本院2009—2013年间完全手术切除、术后分期为Ⅲ_A (N₂)的NSCLC患者资料199例，用Cox模型进行转移、复发多因素分析，用Kaplan-Meier法生存分析并Logrank检验。结果 199例患者中有完整随访资料的173例，1、2年转移率，复发率和生存率分别为38.7%、52.6%，27.8%、39.1%和92.5%、51.4%。多因素分析发现病理类型、术前CEA/CY211/SCC中两项阳性是转移的危险因素(P=0.013、0.014)，阳性淋巴结数、淋巴结转移站数、淋巴结转移率、术前CEA/CY211/SCC中两项阳性是复发危险因素(P=0.046、0.004、0.028、0.001)。相应患者的生存率下降(P=0.013、0.011、0.002、0.026)。

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	刘月姣
	李晓敏
	武静
	李琦
	武亚娟
	任雅琼
	任跃君

关键词 ：癌, 非小细胞肺/外科学, 肿瘤转移, 术后, 肿瘤复发, 术后, 选择放疗

Abstract： Objective To investigate the factors associated with postoperative metastasis, recurrence, and survival in patients with stage Ⅲ_A (N₂) non-small cell lung cancer (NSCLC), and to provide an objective basis for postoperative radiotherapy in patients. Methods Clinical data were collected from 199 patients who underwent complete resection and were diagnosed with stage Ⅲ_A (N₂) NSCLC after surgery in our hospital from 2009 to 2013. The Cox regression model was used for the multivariate analyses of metastasis and recurrence. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. Results In the 199 patients, 173 had complete follow-up data. The 1-and 2-year metastasis, recurrence, and survival rates were 38.7%/52.6%, 27.8%/39.1%, and 92.5%/51.4%, respectively. The multivariate analysis showed that pathological type and two positive indices among preoperative CEA/CY211/SCC were two risk factors for metastasis (P=0.013,0.014). Positive lymph node number, metastatic lymph node number, lymph node metastasis rate, and two positive indices among preoperative CEA/CY211/SCC were risk factors for recurrence (P=0.046,0.004,0.028,0.001). All theabove indices were risk factors for low survival rates (P=0.013,0.011,0.002,0.026). ConclusionsPatients with stage Ⅲ_A (N₂) NSCLC who have positive lymph nodes, lymph node metastases, and two positive indices among preoperative CEA/CY211/SCC may benefit from postoperative radiotherapy.

Key words： Carcinoma,non-small cell lung/surgery Neoplasms metastasis,postoperation Neoplasms recurrence,postoperation Choice radiotherapy

收稿日期: 2015-11-23

通讯作者: 李晓敏,Email:xmli11@163.com

引用本文:

刘月姣,李晓敏,武静等. Ⅲ_A (N₂)期NSCLC术后预后因素分析[J]. 中华放射肿瘤学杂志, 2016, 25(10): 1057-1061.

Liu Yuejiao,Li Xiaomin,Wu Jing et al. An analysis of prognostic factors for stage Ⅲ_A (N₂) non-small cell lung cancer after complete resection[J]. Chinese Journal of Radiation Oncology, 2016, 25(10): 1057-1061.

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