伴实性或微乳头成分IA期肺腺癌的预后分析

Prognostic analysis of minimal solid or micropapillary components on IA lung adenocarcinoma

目的分析IA期肺腺癌患者实性或微乳头成分对预后的影响。方法814例患者分为4组:无实性无微乳头组(S-M-)、有实性无微乳头组(S+M-)、有微乳头无实性组(S-M+)及有实性有微乳头组(S+M+),采用竞争风险模型估算累积复发率(CIR)。结果S-M-较其他3组CIR更低(P<0.001);与S-M+比较,S+M-和S+M+具有更高CIR(P<0.005),多因素分析显示这些差异依然存在。组内分析显示不同比例的实性和微乳头成分患者的CIR差异无统计学意义(P>0.05)。结论实性和微乳头成分是IA期肺腺癌复发转移的独立预后因素,实性成分比微乳头成分更具有侵袭性,判断有无实性或微乳头成分比计算其比例更有意义。

Objective To elucidate the distinct contributions of solid or micropapillary components to lung adenocarcinoma recurrence.Methods A total of 814 IA lung adenocarcinoma was classified into four groups according to the presence of micropapillary or solid component(≥1%):solid and micropapillary absent(S-M-);solid absent and micropapillary present(S-M+);micropapillary absent and solid present(S+M-);solid and micropapillary present(S+M+).Cumulative incidence of recurrence(CIR)was calculated using a competing risk analysis.Results S-M-showed significantly lower five-year CIR than other three groups(P<0.001).S+M-and S+M+showed significantly higher CIR than S-M+(P<0.005).These difference remained significant in multivariable analysis.No significant differences of CIR were found between subgroups of S+M-and S-M+classified according to the ratio of solid or micropapillary components.Conclusions The presence of solid or micropapillary component(≥1%)is an independent risk factor for CIR;solid component reflects a more aggressive nature than micropapillary component.Identifying the presence of solid or micropapillary components is more important than identifying their proportions.