中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2010年
4期
244-246
,共3页
韩炳强%姜格宁%丁嘉安%王海峰%何文新%张鹏%刘明%宋楠%刘志艺
韓炳彊%薑格寧%丁嘉安%王海峰%何文新%張鵬%劉明%宋楠%劉誌藝
한병강%강격저%정가안%왕해봉%하문신%장붕%류명%송남%류지예
肺肿瘤%腺癌%腺癌,细支气管肺泡%肺外科手术%预后%肿瘤复发,局部
肺腫瘤%腺癌%腺癌,細支氣管肺泡%肺外科手術%預後%腫瘤複髮,跼部
폐종류%선암%선암,세지기관폐포%폐외과수술%예후%종류복발,국부
Lung neoplasms%Adenocarcinoma%Adenocarcinoma bronchiolo-alveolar%Pulmonary surgical procedures%Prognosis Neoplasm recurrence,local
目的 比较Ⅰ期细支气管肺泡癌(BAC)和腺癌(non-BAC)的临床特点、复发转移以及预后.方法 回顾性分析1997～2001年期间接受手术治疗的56例Ⅰ期细支气管肺泡癌和169例Ⅰ期腺癌资料,对比两者的生存期以及复发转移情况.结果 全组225例1、3、5年生存率分别为94.7%、83.5%、61.2%,细支气管肺泡癌较同期腺癌显示出更好的生存期(x2=6.36,P=0.012),术后复发主要发生在胸腔内;而腺癌术后胸内复发与胸外转移率基本相等.两组间胸内复发和胸外转移率差异有统计学意义(x2=8.85,P=0.004).细支气管肺泡癌病人中有和无症状者5年生存率分别为58.0%和90.5%(x2=7.28,P=0.007);腺癌中有和无症状病人5年生存率分别为52.6%和70.9%(x2=6.07,P=0.014).同时单因素分析显示,病人性别、年龄(<60岁和≥60岁)、肿物生长部位(双肺上叶和双肺中、下叶)以及吸烟状况无论在BAC组还是腺癌组均与病人的生存期无关(P>0.05).结论 Ⅰ期细支气管肺泡癌预后优于Ⅰ期腺癌,其术后复发多发生在胸腔内;腺癌术后胸内复发与胸外转移率基本相等.早发现早治疗均可提高生存期.
目的 比較Ⅰ期細支氣管肺泡癌(BAC)和腺癌(non-BAC)的臨床特點、複髮轉移以及預後.方法 迴顧性分析1997～2001年期間接受手術治療的56例Ⅰ期細支氣管肺泡癌和169例Ⅰ期腺癌資料,對比兩者的生存期以及複髮轉移情況.結果 全組225例1、3、5年生存率分彆為94.7%、83.5%、61.2%,細支氣管肺泡癌較同期腺癌顯示齣更好的生存期(x2=6.36,P=0.012),術後複髮主要髮生在胸腔內;而腺癌術後胸內複髮與胸外轉移率基本相等.兩組間胸內複髮和胸外轉移率差異有統計學意義(x2=8.85,P=0.004).細支氣管肺泡癌病人中有和無癥狀者5年生存率分彆為58.0%和90.5%(x2=7.28,P=0.007);腺癌中有和無癥狀病人5年生存率分彆為52.6%和70.9%(x2=6.07,P=0.014).同時單因素分析顯示,病人性彆、年齡(<60歲和≥60歲)、腫物生長部位(雙肺上葉和雙肺中、下葉)以及吸煙狀況無論在BAC組還是腺癌組均與病人的生存期無關(P>0.05).結論 Ⅰ期細支氣管肺泡癌預後優于Ⅰ期腺癌,其術後複髮多髮生在胸腔內;腺癌術後胸內複髮與胸外轉移率基本相等.早髮現早治療均可提高生存期.
목적 비교Ⅰ기세지기관폐포암(BAC)화선암(non-BAC)적림상특점、복발전이이급예후.방법 회고성분석1997～2001년기간접수수술치료적56례Ⅰ기세지기관폐포암화169례Ⅰ기선암자료,대비량자적생존기이급복발전이정황.결과 전조225례1、3、5년생존솔분별위94.7%、83.5%、61.2%,세지기관폐포암교동기선암현시출경호적생존기(x2=6.36,P=0.012),술후복발주요발생재흉강내;이선암술후흉내복발여흉외전이솔기본상등.량조간흉내복발화흉외전이솔차이유통계학의의(x2=8.85,P=0.004).세지기관폐포암병인중유화무증상자5년생존솔분별위58.0%화90.5%(x2=7.28,P=0.007);선암중유화무증상병인5년생존솔분별위52.6%화70.9%(x2=6.07,P=0.014).동시단인소분석현시,병인성별、년령(<60세화≥60세)、종물생장부위(쌍폐상협화쌍폐중、하협)이급흡연상황무론재BAC조환시선암조균여병인적생존기무관(P>0.05).결론 Ⅰ기세지기관폐포암예후우우Ⅰ기선암,기술후복발다발생재흉강내;선암술후흉내복발여흉외전이솔기본상등.조발현조치료균가제고생존기.
Objective To compare the clinic characteristics, recurrences and prognosis in patients with stage Ⅰ bronchioloalveolar carcinoma (BAC) and adenocarcinoma of the lung. Methods The data of 56 patients with stage Ⅰ BAC and 169 patients with stage Ⅰ adenocarcinoma were analyzed retrospectively. Results The overall 1-, 3-, 5- year survival rates were 94.7%, 83.5% and 61.2%, respectively. Compared with adenocarcinoma of the lung, BAC showed a better survival rate(x2 =6.36, P =0.012). After surgery patients with BAC were prone to develop intrathoracic recurrence, and adenocarcinoma was equal between intrathoracic recurrence and extrathoracic metastasis. The rate of intrathoracic recurrence and extrathoracic metastasis between BAC and adenocarcinoma was significantly different (14/16 vs. 27/59, x2 =8.85, P=0.004). In both group, preoperative asymptomatic patients had better survival rate(x2 = 7.28, P = 0.007; x2 = 6.07, P = 0. 014). Univariate analysis indicated that sex, age(< 60 years and ≥60 years), location of tumor and smoking history did not significantly influence survival in patients with stage Ⅰ BAC or adenocarcinoma (P > 0.05). Conclusion The prognosis of stage Ⅰ BAC is superior to that of stage Ⅰ adenocarcinoma. BAC is prone to develop intrathoracic recurrence, and adenocarcinoma is equal between intrathoracic recurrence and extrathoracic metastasis. Early diagnosis of lung cancer could improve long-term survival.
