浸润性肺腺癌患者术后预后的相关影响因素分析

Analysis of Related Factors Affecting the Prognosis of Patients with Invasive Adenocarcinoma of the Lung After Surgery

目的探讨影响浸润性肺腺癌患者术后预后的有关因素。方法回顾性分析手术治疗的84例浸润性肺腺癌患者的病历有关资料,按随访截至时间的生存情况将所有患者划分成死亡组(n=14)与存活组(n=70)。收集所有患者的年龄、性别等相关资料,运用多因素Logistic回归分析模型分析影响浸润性肺腺癌患者术后预后的有关因素。结果单因素分析显示:年龄、性别、肿瘤生长部位、肿瘤类型与浸润性肺腺癌患者术后预后无关(P>0.05),术后辅助化疗、肿瘤病理亚型、肿瘤直径、淋巴结转移与浸润性肺腺癌患者术后预后有关(P<0.05);多因素Logistic回归分析显示:术后未行辅助化疗(Wald:7.996,OR:6.250,95%CI:1.755~22.260)、微乳头型浸润性肺腺癌(Wald:10.590,OR:8.000,95%CI:2.286~27.991)、肿瘤直径≥3 cm(Wald:7.440,OR:5.833,95%CI:1.643~20.714)、有淋巴结转移(Wald:11.162,OR:10.593,95%CI:2.653~42.297)为浸润性肺腺癌患者术后预后的重要影响因素(P<0.05)。结论影响浸润性肺腺癌患者术后预后的因素较多,如术后未行辅助化疗、微乳头型浸润性肺腺癌、肿瘤直径≥3 cm、有淋巴结转移等,临床需对上述因素予以高度重视,尽早采取干预措施,改善预后。

Objective To explore the related factors affecting the prognosis of patients with invasive adenocarcinoma of the lung after surgery.Methods The medical records of 84 patients with invasive adenocarcinoma of the lung treated by surgery were retrospectively analyzed.All patients were divided into death group(n=14)and survival group(n=70)according to the survival status at the end of follow-up.The age,sex and other related data of all patients were collected,and the related factors affecting the postoperative prognosis of patients with invasive adenocarcinoma of the lung were analyzed by using the multivariate logistic regression analysis model.Results Univariate analysis showed that age,sex,tumor growth site and tumor type were not related to the postoperative prognosis of patients with invasive Adenocarcinoma of the lung(P>0.05),but postoperative adjuvant chemotherapy,tumor pathological subtypes,tumor diameter,lymph node metastasis were related to the postoperative prognosis of patients with invasive adenocarcinoma of the lung(P<0.05);Multivariate logistic regression analysis showed that no adjuvant chemotherapy(Wald:7.996,OR:6.250,95%CI:1.755~22.260),micropapillary invasive adenocarcinoma of the lung(Wald:10.590,OR:8.000,95%CI:2.286~27.991),tumor diameter≥3 cm(Wald:7.440,OR:5.833,95%CI:1.643~20.714)Lymph node metastasis(Wald:11.162,OR:10.593,95%CI:2.653~42.297)was an important prognostic factor for patients with invasive adenocarcinoma of the lung(P<0.05).Conclusion There are many factors influencing the postoperative prognosis of patients with invasive adenocarcinoma of the lung,such as no adjuvant chemotherapy,micro papillary invasive adenocarcinoma of the lung,tumor diameter≥3 cm,lymph node metastasis,etc.The clinical needs to pay great attention to these factors,and take early intervention measures to improve the prognosis.