恶性孤立性肺结节患者电视胸腔镜手术治疗的预后情况及其影响因素分析

Analysis on the Prognosis of Video-Assisted Thoracoscopic Surgery in the Treatment of Patients with Malignant Solitary Pulmonary Nodules and Its Influencing Factors

目的 分析恶性孤立性肺结节(SPN)患者电视胸腔镜手术治疗的预后情况及其影响因素。方法 150例行电视胸腔镜手术治疗的恶性SPN患者术后随访2年,统计生存与死亡情况。收集患者的临床资料,分析预后的影响因素。结果 150例恶性SPN患者随访期间死亡21例(14.00%)。死亡组的年龄、结节直径均显著大于生存组,家族史占比、吸烟史占比、高血压病史占比、 STK1水平及Ki-67阳性表达占比均显著高于生存组(P<0.05)。COX多因素生存分析显示,年龄大、有吸烟史、血清STK1水平高、 Ki-67阳性表达是恶性SPN患者电视胸腔镜手术治疗预后不良的危险因素(P<0.05)。结论 年龄大、有吸烟史、血清STK1水平高、 Ki阳性表达会增加恶性SPN患者电视胸腔镜手术治疗的不良预后发生风险,临床应重点关注此类患者并开展相应的防治措施,以有效改善患者的预后。

Objective To analyze the prognosis of video-assisted thoracoscopic surgery in the treatment of patients with malignant solitary pulmonary nodules(SNP)and its influencing factors.Methods 150 patients with malignant SPN who underwent video-assisted thoracoscopic surgery were followed-up for 2 years to count the survival and death cases.The clinical data of the patients were collected and the influencing factors of prognosis were analyzed.Results During the follow-up period,21 of 150 patients with malignant SPN died(14.00%).The age and nodule diameter of the death group were significantly bigger than those of the survival group,and the proportions of family history,smoking history and hypertension history,STK1 level,and proportion of Ki-67 positive expression were significantly higher than those in the survival group(P<0.05).COX multivariate survival analysis showed that older age,smoking history,high serum STK1 level and positive expression of Ki-67 were risk factors for poor prognosis of video-assisted thoracoscopic surgery in patients with malignant SPN(P<0.05).Conclusions Older age,smoking history,high serum STK1 level and positive expression of Ki will increase the occurrence risk of poor prognosis of patients with malignant SPN treated by video-assisted thoracoscopic surgery.Clinical attention should be paid to such patients and corresponding prevention and treatment measures should be carried out to effectively improve the prognosis of patients.