肿瘤体积对Ⅰ期非小细胞肺癌术后患者预后预测价值的研究

Study on prognostic predictive value of tumor volume in patients with stage Ⅰ non-small cell lung cancer

目的探讨肿瘤体积预测Ⅰ期非小细胞肺癌根治术后患者预后的价值。方法回顾性分析2007年1月~2010年12月收入中山大学肿瘤防治中心并接受根治性手术、术后病理为Ⅰ期非小细胞肺癌患者203例,比较肿瘤体积<8.35 cm^3和肿瘤体积≥8.35 cm^3两组患者的总生存率和无病生存期,并纳入COX多因素分析。结果两组在性别、吸烟、病理类型、病理分期、分化程度、支气管壁侵犯方面比较,差异有统计学意义(P<0.05)。在多因素分析中,肿瘤体积是Ⅰ期非小细胞肺癌预后一个独立的预测因子(HR=2.972,95%CI:1.566~5.637,P<0.01)。生存分析结果显示肿瘤体积<8.35 cm^3患者5年总生存率为88.5%,肿瘤体积≥8.35cm^3患者5年OS为74.0%(P<0.01)。肿瘤体积<8.35 cm^3预示更长的无病生存期(P<0.01)。结论肿瘤体积是Ⅰ期非小细胞肺癌OS和PFS的独立预测因素,术前CT测定肿瘤体积有助于评估患者的预后。

Objective To investigate the value of tumor volume in predicting the prognosis of patients with stage I non-small cell lung cancer(NSCLC)after radical surgery.Methods Two hundred and Three patients with radical surgery and postoperative pathology was stageⅠNSCLC from January 2007 to December 2010 in Sun Yat-sen University Cancer Center was retrospectively reviewed.The overall survival and disease-free survival in patients were compared between tumor volume<8.35 cm3 and tumor volume≥8.35 cm3 through COX multivariate analysis.Results There were significant differences between the two groups in terms of characteristics of sex,smoking history,histological type,pathological stage,degree of differentiation and bronchial wall invasion(P<0.05).In multivariate analysis,tumor volume was an independent predictor for the prognosis of stage I NSCLC(HR=2.972,95%CI:1.566-5.637,P<0.01).Survival analysis showed that the 5 year overall survival rates(OS)was 88.5%and 74%in tumor volume<8.35 cm3 group and tumor volume≥8.35 cm3(P<0.01)respectively.Tumor volume<8.35 cm3 indicated a longer progress-free survival(P<0.01).Conclusion Tumor volume is an independent predictor of OS and PFS in stage I NSCLC.Preoperative CT measurement of tumor volume helps to assess the prognosis of patients.