空洞型非小细胞肺癌的预后分析

Prognosis of the cavitating non-small cell lung cancer

目的探讨空洞型非小细胞肺癌的临床病理特征对预后的影响。方法回顾性分析手术治疗的空洞型非小细胞肺癌42例，用Kaplan-Meier法统计生存率，Log-rank进行差异性检验，分析临床病理学特征与预后的关系。将空洞型非小细胞肺癌病人按照性别、年龄、病理类型、淋巴结转移、TNM分期、是否接受术后辅助化疗6个因素与无空洞形成的非小细胞肺癌病例进行1：2匹配，比较空洞组和无空洞组预后有无差异。结果42例空洞型非小细胞肺癌的1、3、5年生存率分别为76．2％、28．6％和14．7％。单因素分析显示空洞直径和有无胸内淋巴结转移明显影响预后。空洞组和无空洞组总的5年生存率差异无统计学意义（P=0．075）。两组中的女性（P=0．040）、年龄小于印岁（P=0．032）、淋巴结转移N0组（P=0．046）、TNM分期Ⅰ期（P=0．048）的5年生存率无空洞组均高于空洞组，差别有统计学意义。结论空洞直径和胸内淋巴结转移情况是影响空洞型非小细胞肺癌预后的重要因素。癌性空洞影响年龄小于60岁、淋巴结转移阴性和TNM分期Ⅰ期的非小细胞肺癌病人的预后，但是否影响女性非小细胞肺癌病人的预后有待研究。

Objective To explore the survival and prognostic status of the cavitating non-small cell lung cancer. Methods A total 42 surgically treated patients with cavitating non-small cell lung cancer were studied retrospectively. Kaplan-Meier was used to analyze the relationship between the prognostic factors and survival time. The cavitaing non-small cell lung cancer were matched 1：2 to the patients with non-small cell lung cancer that there is no cavity in X-ray, for gender, age, histology, lymph nodes dissection, stage, and whether receiving chemotherapy. The two groups were compared using the Lag-rank test. Results The overall 1, 3, 5- year survival rates for cavitating non-small cell lung cancer were 76.2%, 28.6%, and 14.7%, respectively. The diameter of the cavity and lymph nodes status significantly influenced survivals. The overall survival between the two groups of patients showed no significant differences （ P = 0.075）. But the factors of women（ P = 0.040）, younger than 60 years（ P = 0.032）, NO of the lymph nodes dissection group（ P = 0.046）, and staging Ⅰ were significantly influenced 5-year survivals（ P =0.048）. Conclusion The diameter of the cavity and lymph nodes status were correlated with the survival. The carcinomatous cavity are important prognosis factors for the non-small cell lung cancer patients of younger than 60 years, negative of lymph nodes dissection and staging Ⅰ , but whether the carcinomatous cavity are important prognosis factors for the non-small cell lung cancer patients of woman was not determined.