胸腔镜术后肺腺癌患者的无瘤生存分析

Analysis of disease-free survival with lung adenocarcinoma undergoing thoracoscopic surgery

目的探讨胸腔镜手术治疗后肺腺癌患者的无瘤生存情况及其影响因素。方法回顾性分析2015年7月至2017年1月安徽省胸科医院122例胸腔镜手术肺腺癌患者的临床资料,运用Kaplan-Meier法计算无瘤生存率,对影响患者术后无瘤生存的影响因素使用log-rank检验及Cox回归方法进行单因素及多因素分析。结果122例胸腔镜治疗肺腺癌患者出院后随访36~54个月,中位随访时间41个月,平均无瘤生存时间45.57(95%CI:42.938~48.193)个月,总体1、2及3年无瘤生存率分别为94.26%、85.25%和78.69%。Cox多因素回归分析显示,年龄≥60岁、病理分期为ⅡB期、ⅢA期、Ⅳ期,淋巴结转移,病灶>3 cm是影响肺腺癌患者术后无瘤生存的危险因素(P<0.05)。结论年龄、TNM分期、淋巴结转移、病灶大小是行胸腔镜手术治疗肺腺癌患者无瘤生存的影响因素。

Objective To investigate the disease-free survival of patients with lung adenocarcinoma after thoracoscopic surgery and its influencing factors.Methods The clinical data of 122 patients with lung adenocarcinoma undergoing thoracoscopic surgery were analyzed by regression analysis.Kaplan Meier method was used to draw the disease-free survival curve of patients with lung adenocarcinoma after thoracoscopic surgery,and the disease-free survival rate was calculated.The influencing factors of disease-free survival were analyzed by log rank test and Cox regression.Results A total of 122 patients were followed up for 36~54 months after discharge.The median follow-up time was 41 months.The average disease-free survival time was 45.57(95%CI:42.938~48.193)months.The 1-year,2-year and 3-year disease-free survival rates was 94.26%,85.25%and 78.69%respectively.Cox multivariate regression analysis showed that age≥60 years,pathological stage of stage IIB,stage IIA and stage IV,lymph node metastasis,and lesions>3 cm were independent risk factors for tumor free survival of patients with lung adenocarcinoma(P<0.05).Conclusion Age,TNM stage,lymph node metastasis and lesion size are the influencing factors of tumor free survival in patients with lung adenocarcinoma after VATS.