1091例肺癌患者的预后分析

Prognostic Analysis of 1091 Cases of Lung Cancer

目的 探讨影响肺癌预后的重要因素。方法 对 10 91例原发性肺癌病例 ,分析年龄、临床分期、病理类型和不同疗法等对预后的影响 ,用乘积限法 (productlimit)计算生存率 ,用对数秩和检验 (logranktest)其显著性。 结果 本组肺癌总的 1、3、5年生存率分别为 2 9.6 %、9.4%、5 .0 %。不同年龄组 5年生存率 :40～ 5 0岁 7.3 % ,高于其它各年龄组 (P <0 .0 1)。不同病理类型 5年生存率 :鳞癌 13 .2 % ,腺癌 9.5 % ,小细胞癌最差为 0 (P <0 .0 5 )。不同临床TNM分期 5年生存率 :Ⅰ～Ⅲa期分别为 17.0 %、9.5 %、1.9% ,Ⅲb和Ⅳ期均为 0 (P <0 .0 5 )。不同治疗方法 5年生存率 :手术治疗为 18.1% ,非手术治疗为 0 .0 2 % ;手术治疗中不同手术术式肺叶切除 2 5 .7% ,全肺切除 10 .8% (P <0 .0 5 ) ,且单纯手术治疗 2 2 .1% ,高于手术加综合治疗 ,但无显著性差异 (P >0 .0 5 ) ;非手术治疗中放疗加化疗为 2 .4% ,其它治疗均为 0 (P <0 .0 5 )。结论 年龄、病理类型、临床分期、不同治疗方法是影响预后的重要因素。

Objective To explore the prognostic factors of lung cancer.Methods 1 091 cases of primary lung cancer were analysed in age、clinical stage、pathology and therapy.Product-limit method was used to calculate the survival rate,its significance was tested by logrank test.Results The overall 1、3、5 year survival rate was 29.6%、9.4%、5.0% respectively.The 5-year survival rate of 40～50 years old patients was higher than those of others(P<0.05).The 5-year survival rate was 13.2% for squamous carcinoma, 9.5% for adenocarcinoma,0 for small cell carcinoma(P<0.05).The 5-year survival rate was 17.0% in stage Ⅰ,9.5% in stage Ⅱ,1.9% in stage Ⅲa,0 in stage Ⅲb and Ⅳ(P<0.05).The 5-year survival rate was 18.1% in treatment with operation,0.02%,without operation.The 5-year survival rate was 25.7% in lobectomy and 10.8% in pneumonectomy(P<0.05).The 5-year survival rate for surgery alone(22.1%) was higher than those for operation plus radiotherapy and/or chemotherapy,but there was not significant difference(P>0.05).The 5-year survival rate was 2.4% for radiotherapy and chemotherapy group and 0 for other treatment without operation(P<0.05).Conclusion Age、pathology、clinical stage and different treatment were important factors affecting prognosis of lung cancer.