肺肉瘤样癌临床预后因素分析

Clinical prognostic factors of pulmonary sarcomatoid carcinoma

目的探讨肺肉瘤样癌(PSC)的临床预后因素。方法收集2017年6月至2020年6月郑州大学第一附属医院收治的54例肺肉瘤样癌患者的临床病理资料,分别对其临床病理特征、治疗方法及预后等因素进行预后分析。结果患者1 a总生存率为35.2%,中位生存时间为9个月。单因素分析显示,年龄(P=0.028)、有无淋巴结转移(P=0.015)、是否远处转移(P=0.008)、T分期(P=0.008)、TNM分期(P=0.008)、是否手术(P<0.001)和治疗方法(P=0.001)是影响预后的因素。多因素分析显示,年龄(P=0.021)、是否远处转移(P=0.035)、T分期(P=0.022)和是否手术(P=0.008)是影响预后的独立危险因素。结论影响PSC预后的独立危险因素主要为年龄、T分期、有无远处转移和是否手术,目前手术根治是治疗PSC的关键,靶向治疗和免疫治疗是其治疗的新方向。

Objective To analyze the clinical prognostic factors of pulmonary sarcomatoid carcinoma(PSC).Methods The clinical data of 54 patients with sarcomatoid carcinoma of the lung were collected from June 2017 to June 2020 in the first affiliated hospital of Zhengzhou university,and the prognostic analysis of their clinicopathological characteristics,treatment methods and prognostic factors were carried out.Results The 1-year overall survival rates were 35.2%.The median survival time was 9 months.Univariate analysis showed that age(P=0.028),lymph node metastasis(P=0.015),distant metastasis(P=0.008),T stage(P=0.008),TNM stage(P=0.008),surgery(P<0.001)and treatment(P=0.001)were the prognostic factors.Multivariate analysis showed that age(P=0.021),distant metastasis(P=0.035),T stage(P=0.022)and operation(P=0.008)were independent risk factors for prognosis.Conclusion The independent risk factors affecting the prognosis of PSC are age,T stage,distant metastasis and operation.At present,radical surgery is the key to PSC treatment,and targeted therapy and immunotherapy are the new directions of PSC treatment.