非小细胞肺癌组织学分型在不同肿瘤大小亚组中的预后意义

Prognostic role of histologic type in non-small cell lung cancer according to different tumor sizes

目的:评价非小细胞肺癌组织学分型在手术预后中的地位,以及在肿瘤分期中的应用范围和可行性。方法:回顾性分析1081例非小细胞肺癌患者术后的预后情况,比较鳞癌和腺癌患者的生存差异,分析肿瘤大小与组织学分型和淋巴结转移之间的相关性。结果:可手术切除非小细胞肺癌肿瘤最大直径≤3cm的亚组中,腺癌和鳞癌的生存率无明显差异(P>0.05);而在肿瘤最大直径>3cm的亚组中,腺癌的生存率明显低于鳞癌(P<0.05)。组织学分型与淋巴结转移无显著相关性(P<0.05)。结论:组织学分型对于特定的非小细胞肺癌患者具有预后预测价值,肿瘤最大直径>3cm的腺癌患者的预后不如鳞癌患者。肿瘤大小可能具有区分不同组织学分型预后差异的能力。

Objective： To evaluate the role of histology in prognosis of patients with non-small cell lung cancer （NSCLC） after lung cancer surgery, and to explore its application and feasibility in clinical TNM staging. Methods： To retrospectively analyze the prognosis of 1 081 cases of NSCLC undergoing radical pneumonectomy and the difference in survival between patients with adenocarcinoma and squamous cell carcinoma. The correlation among tumor size, histology and lymph node status were also evaluated. Results： There was no significant difference in overall survival between adenocarcinoma and squamous cell carcinoma in the subgroup of tumor 3 cm or less in diameter （P 〉 0.05）; but if the diameter was greater than 3 cm, the survival rate of patients with adenocarcinoma was significantly lower than that of the patients with squamous cell carcinoma （P 〈 0.05）. Histology had no significant correlation with lymph node status. Conclusion： Histologic type may be a predictor in the prognosis of selected patients with NSCLC, which means that the patients with adenocarcinoma whose tumor is larger than 3 cm in diameter has a poor prognosis as compared with the patients with squamous cell cancer. The tumor size may be useful in prognosis evaluation of different histology.