Ⅰ期浸润性肺腺癌临床病理特征及预后分析

Clinical and Pathological Characteristics and Prognostic Analysis of StageⅠLung Invasive Adenocarcinoma

目的分析Ⅰ期浸润性肺腺癌患者的临床病理学特征与预后的相关性,探索影响Ⅰ期浸润性肺腺癌患者预后的危险因素。方法纳入行肺结节手术切除,且术后病理明确诊断为Ⅰ期浸润性肺腺癌的患者203例。采用查阅复诊病例资料或电话随访的方式,对患者临床资料、病理学资料及预后资料进行回顾性分析。结果203例患者中,男性81例,女性122例,男女比例为1∶1.51,平均年龄(59.49±9.12)岁,1、2年无进展生存率分别为96.55%、92.12%,1、2年总生存率分别为99.51%、99.01%。单因素分析显示,女性、分期ⅠB期、高级别组分存在、术后辅助治疗与术后无进展生存期(PFS)相关,高级别结构存在、亚肺叶切除术、术后辅助治疗与术后总生存期(OS)相关(P均<0.05);多因素分析显示,男性及高级别结构存在为术后PFS降低的独立危险因素(P均<0.05);亚肺叶切除术与高级别结构存在为术后OS降低的独立危险因素(P均<0.05)。结论高级别结构的存在是Ⅰ期浸润性肺腺癌术后复发、肺癌相关死亡风险增加的独立危险因素。

Objective To analyze the correlation between the clinicopathological characteristics and prognosis of patients with stage I invasive lung adenocarcinoma,and to explore the risk factors affecting the prognosis of patients with stageⅠinvasive lung adenocarcinoma.Methods Patients were pathologically diagnosed with stageⅠinvasive lung adenocarcinoma after surgery were included.Follow-up was carried out by reviewing the records of follow-up visits or via telephone,with the starting point being the date of the patient's surgery and concluding on September 1,2022.A retrospective analysis was performed on their clinical data,pathological data,and prognostic information.Results Among the 203 patients,81 were males and 122 were females,with a male-to-female ratio of 1∶1.51,the average age was(59.49±9.12)ages.The 1-and 2-year progression-free survival rates were 96.55%and 92.12%,respectively,While the 1-and 2-year overall survival rates were 99.51%and 99.01%,respectively.Univariate analysis showed that female gender,stageⅠB,the presence of high-grade components,and postoperative adjuvant therapy were related to postoperative PFS,the presence of high-grade components,sublobar resection,and postoperative adjuvant therapy were related to postoperative OS(P all<0.05);Multivariate analysis indicated that male gender and the presence of high-grade structures were independent risk factors for reduced postoperative PFS(P all<0.05);sublobar resection and the presence of high-grade structures were independent risk factors for reduced postoperative OS(P all<0.05).Conclusion The presence of high-grade components is an independent risk factor for increased risk of postoperative recurrence and lung cancer-related mortality in patients with stageⅠinvasive adenocarcinoma.