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目的分析多形性肺癌的外科治疗以及有无淋巴结转移对患者预后的影响。方法 2001年1月至2013年8月进行手术治疗的多形性肺癌患者24例,年龄45~77岁。其中中央型肺癌6例,周围型肺癌18例。术后随访60~112个月。Kaplan—Meier法计算生存率,Logrank法进行生存率的差异性检验。结果 24例术后病理确诊为多形性肺癌,ⅠA期2例,ⅠB期4例,ⅡA期6例,ⅡB期6例,ⅢA期6例。有淋巴结转移12例,其中N1 8例,N24例。均予手术治疗,其中行完全切除20例,行肉眼根治切除(镜检切缘显示阳性)4例。无手术死亡病例。24例患者3、5年生存率分别为41.67%、29.17%,无淋巴结转移患者(12例)3、5年生存率分别为45.00%、35.00%,有淋巴结转移者(12例)3、5年生存率分别为33.33%、25.00%。有无淋巴结转移患者3、5年生存率差异有统计学意义(P=0.023)。结论多形性肺癌预后差,应早期手术。有无淋巴结转移是影响患者预后的重要因素。
Objective To analyze the effect of surgical treatment of pleomorphic lung cancer and the prognosis of patients with or without lymph node metastasis. Methods Twenty-four patients with pleomorphic lung cancer undergoing surgical treatment from January 2001 to August 2013 were aged 45 to 77 years old. Six cases of central lung cancer, peripheral lung cancer in 18 cases. Follow-up 60 ~ 112 months after operation. Kaplan-Meier method to calculate survival rate, Logrank method to test the difference of survival rate. Results Twenty-four patients were diagnosed as pleomorphic lung cancer by pathology. There were 2 cases of stage IA, 4 cases of stage IB, 6 cases of stage IIA, 6 cases of stage IIB and 6 cases of stage IIA. There are 12 cases of lymph node metastasis, including N1 8 cases, N24 cases. All patients underwent surgical resection, of which 20 cases were completely resected and 4 cases were treated by macroscopic resection. No surgical deaths. The 3-year and 5-year survival rates of 24 patients were 41.67% and 29.17%, respectively. The 3-year and 5-year survival rates were 45.00% and 35.00% in patients without lymph node metastasis (12 cases), and those with lymph node metastasis The annual survival rates were 33.33% and 25.00% respectively. The 3-year and 5-year survival rates of patients with or without lymph node metastasis were significantly different (P = 0.023). Conclusions Prognosis of pleomorphic lung cancer is poor and early surgery should be performed. Whether lymph node metastasis is an important factor affecting the prognosis of patients.