电视胸腔镜下肺癌切除术后患者预后影响因素分析

Analysis of the Influencing Factors for Prognosis of Patients with Lung Cancer Treated by Videoassisted Thoracoscopic Lobectomy

目的探讨电视胸腔镜(VAT)下肺癌切除术后影响患者预后的因素。方法选择2009年2月至2013年2月冀中能源邢台矿业集团有限责任公司总医院收治的103例VATs下行肺癌切除术治疗的患者,随访观察其术后3年和5年生存率,同时回顾性分析患者的临床资料,分析影响患者预后的因素。结果患者术后3年和5年的生存率分别为66.0%(68/103)、45.6%(47/103);单因素分析显示,性别、临床病理分期、分化程度、脉管内瘤栓以及术后规范化疗是影响患者预后的因素(P<0.05);多因素分析显示,临床病理分期、脉管内瘤栓是影响患者预后的危险因素,而术后规范化疗为影响患者预后的保护性因素(P<0.05)。结论临床病理分期、脉管内瘤栓以及术后规范化疗是影响VAT下肺癌切除术后患者预后的独立因素,因此及早诊断、尽早设计个性化治疗方案,选择适宜术式并进行规范的术后化疗可提高患者术后生存率。

Objective To explore the influencing factors on the prognosis of patients with lung cancer treated by video-assisted thoracoseopie （VAT） lobeetomy. Methods Total of 103 lung cancer patients admitted to Jizhong Energy Xingtai MIG General Hospital from Feb. 2009 to Feb. 2013 and treated by VAT lobectomy were collected, the 3-year and 5-year post-operative survival rate were followed up, and the clinical data of the patients was retrospectively analyzed and the prognosis influencing factors were analyzed. Results The 3-year and 5-year survival rates were 66.0% （68/103） mad 45.6% （47/103） ,respectively. Univariate analysis showed that gender, clinical pathological staging, degree of differentiation, intravascular tumor thrombus and standard postoperative chemotherapy were the prognosis influencing factors （ P 〈 0.05 ）. Multi- variate analysis showed that clinical pathological staging, intravascular tumor thrombus were the risk factors affecting the prognosis of patients, and standard postoperative chemotherapy was the protection factor （ P 〈 0.05 ）. Conclusion Clinical pathological staging, intravascular tumor thrombus and standard postoperative chemotherapy are the factors affecting the prognosis of patients with lung cancer treated by VAT lobectomy, so early diagnosis, individualized therapeutic schedule, appropriate surgical approach, and standardized postoper- ative chemotherapy can improve the survival rate.