摘要
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—Me＆r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寺预测因子。
Objective To investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic car- cinoma. 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 eicatricial 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 NO 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 car- einoma of the lung was often found as a large mass peripherally located and was associated with poor prognosis. Radical resec- tion and nodal status were significant independent prognostic factors.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2012年第11期655-658,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
肺肿瘤
多形性癌
胸外科手术
淋巴结
病理类型
Lung neoplasms Pleomorphic carcinoma Thoracic surgical procedures Lymph node Pathological type
