早期非小细胞肺癌患者胸腔镜肺段切除治疗预后的影响因素分析

Analysis of prognostic factors of patients with early non small cell lung cancer video-assisted thoracic surgery

目的分析早期非小细胞肺癌(NSCLC)患者胸腔镜(VATS)肺段切除治疗预后的影响因素,以期为临床预防提供参考。方法回顾性分析2016年8月至2020年1月于本溪市中心医院心胸外科行VATS肺段切除术治疗的123例早期NSCLC患者的临床资料,所有患者术后均随访1年,采用单因素及多因素Logistic回归分析法分析影响早期NSCLC患者VATS肺段切除术后预后不良的相关因素。结果123例早期NSCLC患者预后不良45例,发生率为36.59%。预后不良患者肿瘤直径、术后并发症、辅助化疗与预后良好患者比较差异有统计学意义(P<0.05);两组性别、年龄、体重指数、美国麻醉师协会(ASA)分级、肿瘤TMN分期、长期吸烟史、合并高血压、合并糖尿病、手术病理结果、淋巴结侵犯比较差异无统计学意义。Logistic回归分析结果显示,肿瘤直径≥2cm、术后有并发症、无辅助化疗为早期NSCLC患者VATS肺段切除术后预后不良的危险因素(OR>1,P<0.05)。结论肿瘤直径≥2cm、术后有并发症、无辅助化疗为早期NSCLC患者VATS肺段切除术后预后不良的危险因素,临床可据此提出针对性干预方案,以改善患者预后。

Objective To analyze the prognostic factors of patients with early non small cell lung cancer(NSCLC)videoassisted thoracic surgery(VATS)segmentectomy,and to provide reference for clinical prevention.Methods The clinical data of 123 patients with early NSCLC who underwent VATS segmentectomy in the department of Cardiothoracic Surgery of Benxi Central Hospital from August 2016 to January 2020 were retrospectively analyzed.All patients were followed up for 1 year after operation,univariate and multivariate Logistic regression were used to analyze the factors affecting the poor prognosis of patients with early NSCLC after VATS segmentectomy.Results 123 cases of early NSCLC patients with poor prognosis in 45 cases,the incidence rate was 36.59%.There were significant differences in tumor diameter,postoperative complications and adjuvant chemotherapy between patients with poor prognosis and patients with good prognosis(P<0.05);there was no significant difference in gender,age,body mass index,American Society of Anesthesiologists(ASA)grade,tumor TMN stage,longterm smoking history,hypertension,diabetes,surgical pathological results and lymph node invasion between the two groups.Logistic regression analysis showed that tumor diameter≥2 cm,postoperative complications and no adjuvant chemotherapy were risk factors for poor prognosis after VATS segmentectomy in patients with early NSCLC(OR>1,P<0.05).Conclusion Tumor diameter≥2 cm,postoperative complications,and no adjuvant chemotherapy are risk factors for poor prognosis after VATS segmentectomy in patients with early NSCLC.Clinically,targeted intervention programs can be proposed to improve the prognosis of patients.