原发性肺癌患者病理特征及预后分析

Pathological Characteristics and Prognosis of Patients with Primary Lung Cancer

目的分析原发性肺癌患者的临床特征与其预后的关系。方法284例原发性肺癌患者根据年龄分为年轻组(<50岁)和中老年组(>50岁),比较两组在性别、肿瘤位置、组织学类型、临床分期、治疗方式、淋巴结转移情况、脉管侵袭情况、合并呼吸道感染、合并糖尿病、合并其他心血管疾病及疾病控制等临床特征的差异,并应用单因素和多因素分析的方法分析影响预后的临床病理因素。结果不同年龄大小的原发性肺癌患者在性别、肿瘤位置、组织学类型方面差异无统计学意义(P均>0.05);两组患者在临床分期、治疗方式、淋巴结转移情况、脉管侵袭及疾病控制等方面比较,差异均有统计学意义(P均<0.05);对原发性肺癌患者随访6~18个月后,患者总体疾病控制率为71.47%,单因素分析显示,年龄、临床分期、淋巴结转移、脉管侵袭对患者疾病控制率均有影响(P<0.05)。Cox比例危险回归模型多因素分析显示,年龄、临床分期、淋巴结转移、脉管侵袭是预后的影响因素。结论原发性肺癌以腺癌为主,年轻原发性肺癌恶性程度高,但预后较好,原发性肺癌早发现并防止转移有利于患者预后。

Objective To analyze the relationship between clinical features and prognosis in patients with primary lung cancer.Methods 284 patients with primary lung cancer.According to age,they were divided into young group(<50 years old)and middle-aged group(>50 years old).The gender,tumor location,histological type,clinical stage,treatment mode,lymph node metastasis,vascular invasion and merger were compared between the 2 groups.Differences in clinicopathological features such as respiratory tract infection,combined with other cardiovascular diseases and objective response rates,and the use of univariate and multivariate analysis methods to analyze the prognostic clinical and pathological factors.Results There were no significant differences in gender,tumor location,and histological type between primary lung cancer patients of different ages(P>0.05).Clinical stage,treatment,lymph node metastasis,and vascular invasion were observed in the 2 groups.There were significant differences in the incidence of respiratory infection,combined with other cardiovascular diseases and disease control rate(P<0.05).The overall disease control rate of patients with primary lung cancer after 6~18 months of follow-up was 71.47%,univariate analysis showed that age,clinical stage,lymph node metastasis,and vascular invasion had an effect on disease control rate(P<0.05).Multivariate analysis of the Cox proportional hazard regression model showed that clinical stage,lymph node metastasis,and vascular invasion were independent prognostic factors.Conclusion Primary lung cancer is mainly adenocarcinoma.Young primary lung cancer has a high degree of malignancy,but the prognosis is good.Early detection and prevention of metastasis of primary lung cancer is beneficial to the prognosis of patients.