论文部分内容阅读
目的探讨影响IIIA期N2非小细胞肺癌(NSCLC)预后的因素,并分析经手术治疗不同亚组病人的生存率差异。方法分析1997年1月至2000年1月146例手术治疗的IIIA期N2NSCLC病人的可能影响预后因素:病理类型、肿瘤位置、肿瘤大小、手术方式、临床N2情况,N2转移组数及个数、术后辅助治疗等,并用Kaplan-Meier曲线及Logrank检验生存率差异,Cox单因素、多因素分析各因素对生存率的影响。结果IIIA期N2NSCLC病人的3年和5年生存率分别为19.86%和14.56%。单因素分析示肿瘤位置、临床N2情况、N2转移组数及个数是影响生存率的因素;多因素分析示肿瘤大小、临床N2情况,N2转移组数和肿瘤位置影响预后。右肺下叶肿瘤单组或单个N2转移,预后最好。结论纵隔N2转移淋巴结的大小、个数和组数是影响术后生存率主要因素。手术前未发现N2转移(mN2),有1组N2转移(N2L1),N2转移数少于4个者手术治疗效果好。右肺下叶肿瘤发生单组N2淋巴结转移预后好。
Objective To investigate the factors influencing the prognosis of stage IIIA N2 non-small cell lung cancer (NSCLC) and to analyze the differences in the survival rates among the different subgroups treated surgically. Methods The prognostic factors of 146 patients with stage IIIA N2NSCLC from January 1997 to January 2000 were analyzed. The prognostic factors were pathological type, tumor location, tumor size, operation mode, clinical N2 status, number and number of N2 metastasis group, Postoperative adjuvant therapy, and Kaplan-Meier curves and Logrank test survival difference, Cox single factor, multivariate analysis of the impact of various factors on survival. Results The 3-year and 5-year survival rates of patients with stage IIIA N2NSCLC were 19.86% and 14.56%, respectively. Univariate analysis showed that tumor location, clinical N2 status, N2 metastasis number and number were the factors affecting survival rate. Multivariate analysis showed tumor size, clinical N2 status, N2 metastasis group number and tumor location prognosis. Lower right lung tumor single or single N2 metastasis, the best prognosis. Conclusion The size, number and number of lymph nodes in mediastinal N2 lymph nodes are the main factors affecting the postoperative survival rate. No N2 metastasis (mN2), N2L1 (N2L1), and less than 4 N2 metastases were observed before surgery. Right lung lobe tumor with a single group of N2 lymph node metastasis prognosis is good.