单纯细支气管肺泡癌42例生存率及预后因素探讨

Studies on factors affecting the prognosis of 42 patients with pure bronchioloalveolar carcinoma

目的探讨影响单纯型细支气管肺泡癌(BAC)患者的预后因素。方法根据2004年BAC最新定义,在156例BAC中选取符合标准的单纯型BAC42例进行回顾性分析,按首次就诊时有无临床症状、TNM分期、影像学分型以及细胞生物学指标Ki67、p53进行分组配对,先用χ2检验最后用Cox模型分析处理各组数据。结果42例患者中位生存时间50个月,其1、2、3、5年总生存率分别为100%、95%、84%、62%;按TNM分期,Ⅰ+Ⅱ期和Ⅲ+Ⅳ期患者的1、2、3、5年生存率分别为100%、95%、92%、86%和100%、90%、74%、53%(P<0.05)。首诊时患者有无症状、影像学分型以及细胞p53表达也与生存预后相关。Cox多因素分析提示首诊时有无症状和TNM分期是独立的预后影响因子。结论影响单纯BAC5年生存率的主要因素有患者首诊时有无临床症状及TNM分期,总体生存率较高。

Objective To explore the factors that affecting the prognosis of early stage pure bronchioloalveolar carcinoma（BAC）.Methods Reference to the latest identification of BAC in 2004,42 patients with pure BAC from 156 BAC patients were studied retrospectively.According to the symptoms appeared or not,TNM staging,imaging typing and the expressions of cell p53,Ki67,the patients were divided into groups and the 1-year,2-year,3-year,and 5-year survive rate of them were obtained respectively.The χ2 test and Cox modal analysis were used to compare the difference of survivals between/among the groups.Results The overall 1-year,2-year,3-year,and 5-year survival rate was 100%,95%,84% and 62%,with median survival time（MST）fifty months.The rates were 100%,95%,92%,86% and 100%,90%,74%,53% in the groups of TNM stage Ⅰ＋Ⅱ and Ⅲ＋Ⅳ,respectively（P〈0.05）.There were lower survivals in the symptomatic group,the pneumonia typing group and high cell express p53 group.Cox regression analysis suggests that symptoms and TNM stage are independent factors affecting progresis.Conclusions The factors affecting the survival rate of pure BAC patients are the clinical manifestations of the patients,TNM stage.Overall survival rate was superior to other NSCLC.