CAJ | 학술논문

目的分析Ⅰ期非小细胞肺癌(NSCLC)患者术中淋巴结(LN)的切除数量对预后的影响.方法回顾性分析1998年1月-2002年12月5年间在首都医科大学附属北京友谊医院接受手术治疗的74例Ⅰ期非小细胞肺癌患者临床、病理和随访资料.根据术中切除淋巴结的数量,将全部患者分组,运用Kaplan-Meier生存分析和Cox比例风险模型,对影响预后的因素进行单因素和多因素分析.结果 74例患者5年生存率为64.9%,5年无病生存率为47.3%.单因素分析显示,肿瘤大小(P=0.016)、T分期(P=0.008)和淋巴结清扫范围(P=0.013)会影响患者的生存率,淋巴结切除数量少于6枚的患者生存率和无病生存率明显低于切除淋巴结数量在6枚以上者.多因素分析结果显示淋巴结切除数量和分期均是影响患者预后的因素.结论患者的生存率与术中淋巴结切除数量呈正相关.研究数据表明,在Ⅰ期非小细胞肺癌患者手术中至少应该切除6个以上淋巴结.
목적 분석Ⅰ기비소세포폐암(NSCLC)환자술중림파결(LN)적절제수량대예후적영향.방법 회고성분석1998년1월-2002년12월5년간재수도의과대학부속북경우의의원접수수술치료적74례Ⅰ기비소세포폐암환자림상、병리화수방자료.근거술중절제림파결적수량,장전부환자분조,운용Kaplan-Meier생존분석화Cox비례풍험모형,대영향예후적인소진행단인소화다인소분석.결과 74례환자5년생존솔위64.9%,5년무병생존솔위47.3%.단인소분석현시,종류대소(P=0.016)、T분기(P=0.008)화림파결청소범위(P=0.013)회영향환자적생존솔,림파결절제수량소우6매적환자생존솔화무병생존솔명현저우절제림파결수량재6매이상자.다인소분석결과현시림파결절제수량화분기균시영향환자예후적인소.결론 환자적생존솔여술중림파결절제수량정정상관.연구수거표명,재Ⅰ기비소세포폐암환자수술중지소응해절제6개이상림파결.
Objective To investigate the prognostic effect of quantity of lymph node(LN)resected in operations of patients with stage Ⅰ non-small cell lung cancer(NSCLC).Methods The clinical, pathological and follow-up data of 74 patients with stage Ⅰ NSCLC who were treated with surgery from January 1998 to December 2002 Beijing Friendship Hospital, Affiliated to Capital Medical University were reviewed retrospectively.Grouping the patients, according to the quantity of lymph node resected, the Kaplan-Meier method and Cox proportional hazards model was used for univariate analysis and multivariate analysis of factors with prognostic effect.Results The five year survival rate and disease-free survival(DFS)rate of these 74 patients were 64.9% and 47.3%.The univariate analysis showed that tumor size(P =0.016),T-staging (P =0.008)and extent of lymph node dissection(P =0.013)could influence the survival rate.The 5-year OS and DFS rates of patients with less than 6 LNs resected were less than the other group(more than 6 LNs)apparently.The multifactorial analysis indicated that other than staging, the quantity of lymph node resected was also an influence factor of prognosis.Conclusions The OS rate of patients has positive correlation with quantity of lymph node resected in operations.Six LNs must be resected leastways in operations of patients with stage Ⅰ NSCLC.