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目的探讨亚肺叶切除、肺叶切除对T1a,b N0M0期非小细胞肺癌(non-small cell lung cancer,NSCLC)预后的影响。方法收集2008年4月至2016年4月于海军安庆医院胸外科接受手术治疗(肺叶切除45例、亚肺叶切除38例)的83例T1期NSCLC患者的临床资料,并随访患者生存情况,计算5年生存率,同时进行生存率的单因素、多因素分析。结果 83例患者共死亡14例,总体5年生存率为78.1%。单因素生存分析提示肿瘤大小、淋巴结采样数目是影响生存率的预后因子(P<0.05),而亚肺叶切除及肺叶切除、手术方式、年龄、性别、是否接受术后化疗、病理类型的差异均无统计学意义(P>0.05)。Cox多因素分析提示肿瘤大小、淋巴结采样数目是影响T1a,b N0M0期NSCLC预后的独立影响因子。结论亚肺叶切除与肺叶切除对于pT1a,b N0M0 NSCLC患者具有相似的生存率、并发症发生率、复发转移率;T1期淋巴结采样可延长患者生存率,故术中淋巴结应尽可能的被采样、清扫。
Abstract：Objective To investigate the outcomes of sublobar resection versus lobectomy in patients with stage T1 a,b N0 M0 non-small cell lung cancer(NSCLC).Methods Clinical medical data of 83 patients with stage T1 and NSCLC cancer admitted for surgical treatment in the Thoracic Surgery Department, Navy Anqing Hospital from April 2008 to April 2016 were collected for the study. Of the 83 patients, 45 underwent lobectomy and 38 had sublobar resection. Five-year survival rate was calculated in the study subjects, and at the same time, single and multi-factor analyses were performed by using the Kaplan-Meier method and Cox-regression model.Results Of the 83 cases, 14 died, and totally the 5-year survival rate was 78.1%. Univariate analysis indicated that tumor size and the number of lymph node sampling were prognostic factors affecting survival rate(P<0.05). No statistical significance could be noted in sublobar resection, lobectomy, surgical methods, age, gender, chemical therapy and pathological type, when comparisons were made statistically(P<0.05). Cox-regression analysis indicated that tumor size and the number of lymph node sampling were independent influential factors affecting the prognosis of stage T1 a and b N0 M0 NSCLC.Conclusion Sublobar resection and lobectomy in patients with stage T1 a and b N0 M0 NSCLC displayed identical survival rate, complication rate and rate of recurrence and metastasis. Lymph node sampling at the time of tumor resection could prolong patient survival rate. Therefore, lymph nodes should be sampled and cleaned as much as possible in surgery.
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中图分类号:R734.2
引用信息:
[1]刘一胜,李小平,鲍方,等.亚肺叶切除与肺叶切除对T1a,b N0M0期非小细胞肺癌预后的影响[J].海军医学杂志,2019,40(03):233-236.
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