Ⅲa期非小细胞肺癌患者预后的单中心回顾性分析

A single center retrospective study of the prognosis of stageⅢa non-small cell lung cancer patients

目的探讨第8版非小细胞肺癌TNM分期Ⅲa期患者的预后。方法纳入2001年至2010年间于本溪市中心医院手术且术后未接受任何辅助治疗的Ⅲa期非小细胞肺癌患者215例,将患者分为pT_(2a)N_(2)M_(0)、pT_(2b)N_(2)M_(0)、pT_(3)N_(1)M_(0)和pT_(4)N_(1)M_(0)共4个亚组,分析并比较患者的预后。结果4个亚组间生存率有统计学差异(P<0.05),且pT_(2a)N_(2)M_(0)和pT_(3)N_(1)M_(0)亚组、pT_(2b)N_(2)M_(0)和pT_(3)N_(1)M_(0)亚组、pT_(3)N_(1)M_(0)和pT_(4)N_(1)M_(0)亚组比较,5年生存率也有统计学差异(均P<0.05)。鳞状细胞癌和腺癌患者比较,5年生存率无统计学差异;中分化患者的5年生存率明显高于高分化患者(P<0.05);存在脉管浸润和胸膜浸润患者的5年生存率明显低于无脉管浸润和胸膜浸润的患者(均P<0.05)。结论非小细胞肺癌Ⅲa期各亚组间患者的生存预后有显著差异,建议对当前Ⅲa期亚组进行更细致的分期,以更准确地预测患者预后。

Objective To explore the prognosis of stageⅢa non-small cell lung cancer(NSCLC)patients following the 8th TNM classification.Methods We retrospectively analyzed the clinical data of 215 stageⅢa NSCLC patients who underwent lung resection at Benxi Central Hospital and did not accept any postoperative adjuvant therapy from 2001 to 2010.The patients were divided into four subgroups(pT_(2a)N_(2)M_(0),pT_(2b)N_(2)M_(0),pT_(3)N_(1)M_(0),and pT_(4)N_(1)M_(0)),and the prognosis of the patients were analyzed and compared.Results Significant differences in the 5-year survival rates were found among the four subgroups:between pT_(2a)N_(2)M_(0) and pT_(3)N_(1)M_(0),between pT_(2b)N_(2)M_(0) and pT_(3)N_(1)M_(0),and between pT_(3)N_(1)M_(0) and pT_(4)N_(1)M_(0)(P<0.05).However,no significant difference in the 5-year survival rates was found between squamous cell carcinoma and adenocarcinoma patients.Additionally,the 5-year survival rates in patients with intermediate differentiation were significantly higher than those with high differentiation(P<0.05),and the 5-year survival rates in patients with vessel and pleural invasion were significantly lower than those without vessel and pleural invasion(P<0.05).Conclusion The subclassification of stageⅢa NSCLC has prominent prognostic significance,and thus it is recommended that the current stage should be subclassified to predict patient prognosis with greater accuracy.