248例N0期非小细胞肺癌的预后因素分析

目的:回顾性分析248例N0期非小细胞肺癌的预后因素。方法:本文选取1994年1月～1997年7月间行根治性切除的248例N0期非小细胞肺癌,采用Kaplan-Meier法绘制生存曲线(Log-Rank检验)和COX多因素回归对该组病例的预后因素进行分析。结果:术中同侧肺门和纵隔淋巴结清扫超过6枚的病例生存率高于6枚以下的病例(P=0.005);术后生存率随T1、T2、T3和T4依次明显递减(P<0.001);术后化疗组病例的生存期高于非化疗组(P=0.016);鳞癌和腺癌的生存率高于其他病理类型(P=0.002)。结论:纵隔淋巴结的清扫数量、术后化疗与否、肿瘤的T分期和病理类型是影响N0期非小细胞肺癌预后的主要因素,而性别、术后放疗、术后免疫治疗、手术方式等对预后无明显影响。

Survival and Prognostic Factors in Resected No Non-Small Cell Lung Cancer

Objective:The prognostic factors for N 0 non-small cell lung cancer undergone radical resection were retrospectively reviewed.Methods:The present study comprised248con-secutive patients from Tianjin Cancer Hospital and Institute(1994.1-1997.7)who underwent surgi-cal resection of N 0 NSCLC.Kaplan-meier survival curve and Cox regression model were used to evaluate the prognostic faceors.Results:The patients who were resected more than6lymph nodes in the ipsilateral hilum and mediastina during the operation had a higher survival rate than the others(P=0.005).The survival rates were gradually decreased from T 1 ,T 2 ,T 3 and T 4 (P<0.001).Patients had not received postoperative chemotherapy gave a poorer survival than who had (P=0.016).Patients with squamous carcinoma and adenocarcinoma gave a better survival rate than the other kinds(P=0.002).Conclusion:The number of lymph nodes resected,T stage,postoperative chemotherapy and pathologic type are the main prognostic factors.The other factors had no signif-icant effect of the prognosis.