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探讨非小细胞肺癌术后支气管残端阳性病人的预后影响因素及优化处理方案。方法１９７４．１．１～１９９３．１２．３１连续７１例术后支气管残端阳性的肺癌病人，配以同一时期ＴＮＭ分期相似的根治性手术２１３例，用Ｋａ┐ｐｌａｎ┐Ｍｅｉｅｒ法进行生存分析，用ＣＯＸ比例危险模型对影响预后的因素行单因素和多因素分析。结果残端阳性组的一、三、五、十年累积生存率分别为５９．５％、３２．４％、２５．０％和１９．３％，低于根治术组（Ｂｒｅｓｌｏｗ：７．３７，Ｐ＝０．００６６）。支气管残端阳性、病理类型和淋巴结是否转移这三个变量对预后的影响有统计学上的高度显著性意义，不同的病理类型、淋巴结转移状况、手术清扫范围、辅助治疗方式均呈现不同的生存曲线，但仅Ⅰ、Ⅱ期和Ⅲ期生存曲线的差异有显著性意义（Ｐ＝０．０１９８）。结论非小细胞肺癌术后支气管残端阳性的病人，以没有淋巴结转移的Ⅰ、Ⅱ期肺鳞状细胞癌预后最好。最佳的治疗方式是在纵隔淋巴结清扫的基础上辅以术后放射治疗。
To investigate the prognostic factors and optimize the treatment of patients with non-small cell lung cancer after bronchial stump resection. Methods 1974.1.1 ~ 1993.12.31 consecutive 71 cases of lung cancer patients with positive bronchial stump after surgery, combined with the same period of 213 cases of radical TNM surgery, using Ka┐plan┐ Meier method for survival analysis, Univariate and multivariate analyses were performed on the prognostic factors using the COX proportional hazards model. Results The cumulative survival rate of the stump-positive group was 59.5%, 32.4%, 25.0%, and 19.3%, respectively, lower than that of the radical surgery group (Breslow: 7.37). , P = 0.0066). The positive effects of bronchial stumps, pathological types, and whether or not the lymph nodes were metastasized had statistically significant effects on the prognosis. Different pathological types, lymph node metastases, surgical clearances, and adjuvant treatments all showed different survival. Curves, but only differences in the survival curves of phase I, II, and III were significant (P = 0.0198). Conclusions Patients with positive bronchial stump after non-small cell lung cancer surgery have the best prognosis in stage I and II squamous cell carcinoma without lymph node metastasis. The best treatment is based on mediastinal lymph node dissection followed by postoperative radiation therapy.