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
2012年
11期
655-658
,共4页
吉春宇%赵珩%方文涛%陈文虎
吉春宇%趙珩%方文濤%陳文虎
길춘우%조형%방문도%진문호
肺肿瘤%多形性癌%胸外科手术%淋巴结%病理类型
肺腫瘤%多形性癌%胸外科手術%淋巴結%病理類型
폐종류%다형성암%흉외과수술%림파결%병리류형
Lung neoplasms%Pleomorphic carcinoma%Thoracic surgical procedures%Lymph node%Pathological type
目的 探讨肺多形性癌的外科治疗并分析影响预后的因素,以期提高对肺多形性癌的认识.方法 回顾性分析上海市胸科医院胸外科1999年至2011年收治的60例肺多形性癌临床资料,男性55例,女性5例；年龄45～77岁.周围型肺癌55例,中央型5例.54例行完全切除(R0)；6例行肉眼根治切除,但镜下显示切缘阳性(R1).术后均随访.Kaplan-Meier法计算生存率,Logrank法进行生存率显著性检验,Cox比例风险回归模型进行多因素分析.结果 全组无手术死亡.1例手术当日因血胸行再次开胸止血；1例右上叶支气管袖形切除术后半年因吻合口瘢痕增生导致右余肺不张而行右余肺切除术.60例患者3年、5年生存率分别为47.2％、25.6％.本组患者中无淋巴结转移患者(25例)3年、5年生存率分别为57.3％、32.5％,淋巴结转移者(35例)3、5年生存率为25.4％、17.1％,有无淋巴结转移的患者3年、5年生存率差异有有统计学意义(P=0.017).根治性切除(R0)3年、5年生存率51.5％、30.3％,非根治性切除3年、5年生存率12.5％、0.多因素分析显示,影响预后的独立因素是手术根治程度(P=0.041)及有无淋巴结转移(P =0.029).结论 肺多形性癌预后差,应早期手术.手术根治程度和有无淋巴结转移是患者预后的独立预测因子.
目的 探討肺多形性癌的外科治療併分析影響預後的因素,以期提高對肺多形性癌的認識.方法 迴顧性分析上海市胸科醫院胸外科1999年至2011年收治的60例肺多形性癌臨床資料,男性55例,女性5例；年齡45～77歲.週圍型肺癌55例,中央型5例.54例行完全切除(R0)；6例行肉眼根治切除,但鏡下顯示切緣暘性(R1).術後均隨訪.Kaplan-Meier法計算生存率,Logrank法進行生存率顯著性檢驗,Cox比例風險迴歸模型進行多因素分析.結果 全組無手術死亡.1例手術噹日因血胸行再次開胸止血；1例右上葉支氣管袖形切除術後半年因吻閤口瘢痕增生導緻右餘肺不張而行右餘肺切除術.60例患者3年、5年生存率分彆為47.2％、25.6％.本組患者中無淋巴結轉移患者(25例)3年、5年生存率分彆為57.3％、32.5％,淋巴結轉移者(35例)3、5年生存率為25.4％、17.1％,有無淋巴結轉移的患者3年、5年生存率差異有有統計學意義(P=0.017).根治性切除(R0)3年、5年生存率51.5％、30.3％,非根治性切除3年、5年生存率12.5％、0.多因素分析顯示,影響預後的獨立因素是手術根治程度(P=0.041)及有無淋巴結轉移(P =0.029).結論 肺多形性癌預後差,應早期手術.手術根治程度和有無淋巴結轉移是患者預後的獨立預測因子.
목적 탐토폐다형성암적외과치료병분석영향예후적인소,이기제고대폐다형성암적인식.방법 회고성분석상해시흉과의원흉외과1999년지2011년수치적60례폐다형성암림상자료,남성55례,녀성5례；년령45～77세.주위형폐암55례,중앙형5례.54례행완전절제(R0)；6례행육안근치절제,단경하현시절연양성(R1).술후균수방.Kaplan-Meier법계산생존솔,Logrank법진행생존솔현저성검험,Cox비례풍험회귀모형진행다인소분석.결과 전조무수술사망.1례수술당일인혈흉행재차개흉지혈；1례우상협지기관수형절제술후반년인문합구반흔증생도치우여폐불장이행우여폐절제술.60례환자3년、5년생존솔분별위47.2％、25.6％.본조환자중무림파결전이환자(25례)3년、5년생존솔분별위57.3％、32.5％,림파결전이자(35례)3、5년생존솔위25.4％、17.1％,유무림파결전이적환자3년、5년생존솔차이유유통계학의의(P=0.017).근치성절제(R0)3년、5년생존솔51.5％、30.3％,비근치성절제3년、5년생존솔12.5％、0.다인소분석현시,영향예후적독립인소시수술근치정도(P=0.041)급유무림파결전이(P =0.029).결론 폐다형성암예후차,응조기수술.수술근치정도화유무림파결전이시환자예후적독립예측인자.
Objective To investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma.Methods 60 cases of pleomorphic pulmonary carcinoma were collected and studied clinicopathologically between 1999 and 2011.All patients underwent pulmonary resections.Results There was no in-hospital death.1 had haemothorax that required reoperation,1 patient had a late cicatricial bronchial stenosis after sleeve lobectomy of the upper right lobe,and treated successfully by the resection of the right two lobes.The 3,5-year survival rates of all patients were 47.2％ and 25.6％ respectively.For N0 and N1-N2 patients,3-,5-year survival rates were 57.3％,32.5 ％ and 25.4％,17.1％,respectively.Overall survivals were of significant difference between radical resection and uncomplete resection.Multivariate Cox regression analyses of overall survival of all 60 patients indicated that radical resection (P =0.041) and nodal status (P =0.029) were significant independent prognostic factors.Conclusion Pleomorphic carcinoma is a rare type of lung cancer.Pleomorphic carcinoma of the lung was often found as a large mass peripherally located and was associated with poor prognosis.Radical resection and nodal status were significant independent prognostic factors.
