论文部分内容阅读
目的探讨青年女性肺腺癌的临床病理学特征对预后的影响。方法回顾性分析手术治疗的青年女性肺腺癌282例,用 Kaplan-Meier 法计算生存率,分析临床病理学特征与预后的关系,并且进行Cox回归比例风险模型多因素分析。结果吸烟与非吸烟组5年生存率分别为20.0%与36.4%(P=0.021);p-TNM 各分期5年生存率分别为Ⅰ期65.7%(Ⅰa期66.1%、Ⅰb期60.5%)、Ⅱ期30.9%(Ⅱa期36.3%、Ⅱb期27.5%)、Ⅲ期11.4%(Ⅲa期12.3%、Ⅲb期6.8%)、Ⅳ期3.6%,各期间生存率差异有统计学意义(P<0.001);淋巴结转移个数>3个与≤3个的5年生存率分别为19.1%与38.3%(P=0.006);高、中、低分化的5年生存率为65.2%、29.5%、19.8%(P<0.001)。吸烟、p-TNM 分期、转移淋巴结个数及分化程度与预后密切相关。多因素分析中吸烟、p-TNM 分期和分化程度是独立的预后因素,相对危险比(RR)分别为3.315、2.809、1.195。结论吸烟、p-TNM 分期、转移淋巴结个数及分化程度与青年女性肺腺癌的预后关系密切,吸烟、p-TNM 分期和分化程度是青年女性肺腺癌的独立预后因素。因此,应当积极控制青年人群的吸烟,彻底清扫淋巴结,这对于青年女性肺腺癌预后具有重要意义。
Objective To investigate the clinical and pathological features of lung adenocarcinoma in young women. Methods A retrospective analysis of 282 young female patients with adenocarcinoma of lung cancer treated with Kaplan-Meier method was used to calculate the survival rate. The relationship between clinicopathological characteristics and prognosis was analyzed. Multivariate analysis was performed on the Cox proportional hazards model. Results The 5-year survival rates of smoking and non-smoking groups were 20.0% and 36.4%, respectively (P = 0.021). The 5-year survival rates of each stage were 65.7% (66.1% (36.3% in stage Ⅱa, 27.5% in stage Ⅱb), 11.4% in stage Ⅲ (12.3% in stage Ⅲa and 6.8% in stage Ⅲb), and 3.6% in stage Ⅳ. There was significant difference in the survival rates between the two groups (P <0.001) ). The 5-year survival rates of lymph node metastasis> 3 and ≤3 were 19.1% and 38.3% respectively (P = 0.006). The 5-year survival rates of high, moderate and poorly differentiated were 65.2%, 29.5% and 19.8 % (P <0.001). Smoking, p-TNM stage, the number of metastatic lymph nodes and the degree of differentiation and prognosis are closely related. In multivariate analysis, smoking, p-TNM stage and degree of differentiation were independent prognostic factors. The relative risk ratios (RRs) were 3.315, 2.809 and 1.195, respectively. Conclusion Smoking, the stage of p-TNM, the number of metastatic lymph nodes and the degree of differentiation are closely related to the prognosis of lung adenocarcinoma in young women. Smoking, the stage of p-TNM and the degree of differentiation are the independent prognostic factors of lung adenocarcinoma in young women. Therefore, we should actively control the smoking of young people and thoroughly clean the lymph nodes, which is of great significance for the prognosis of lung adenocarcinoma in young women.