摘要
背景与目的N2期非小细胞肺癌患者预后异质性很强,本研究旨在探索其预后相关因素。方法纳入四川大学华西医院胸外科2007年1月-2016年12月间行根治性切除的N2期患者,使用Cox模型比较临床病理学特征与总体生存率之间的关系,使用Kaplan-Meier法绘制生存曲线,并且根据淋巴结转移情况进行亚组分析。结果总共纳入773例N2期患者,中位随访时间57.2个月,5年总体生存率为34.8%。肿瘤原发灶-淋巴结-远处转移(tumor-nodemetastasis,TNM)分期、多站淋巴结转移、跳跃性转移、脉管侵犯、辅助化疗为预后相关的独立风险因素。T1-3期患者具有相似的预后,T4期患者预后明显更差。单站跳跃性转移的患者预后最好,5年生存率达48.9%。结论N2患者中T4期预后差。在将来的分期中应结合淋巴结转移站数和跳跃性转移进行更精细的N分期划分。
Background and objective Patients with N2 stage non-small cell lung cancer have prognostic heterogeneity,and this study attempted to explore the prognostic factors among those patients.Methods Patients with N2 stage undergoing radical resection in Department of Thoracic Surgery,West China hospital,Sichuan University between January 2007 and December 2016 were included.Cox proportional hazard regression model was used to explore the prognostic value of clinicopathological features.Survival curves were plotted by Kaplan-Meier method.Subgroup analyses considering the situation of lymph node involvement were performed.Results In total,773 patients were included.The median follow-up time was 57.2 months,and the 5-year overall survival rate was 34.8%.Tumor-node-metastasis(TNM)stage,number of involved lymph node stations,skip metastasis,lymphatic or vascular invasion and adjuvant chemotherapy were independent prognostic factors.The patients with stage T1-3 had similar prognosis,while the patients with stage T4 had worse survival.In addition,the patients with single station involvement and skip metastasis had the best prognosis with a 5-years overall survival rate of 48.9%.Conclusion T4 stage patients had worse survival in N2 group.To get a more precisely stratification,skip metastasis and number of involved lymph node stations should be considered in future N stage classification.
作者
杨振宇
韦诗友
夏粱
刘伦旭
Zhenyu YANG;Shiyou WEI;Liang XIA;Lunxu LIU(Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国肺癌杂志》
CAS
CSCD
北大核心
2020年第1期15-20,共6页
Chinese Journal of Lung Cancer
基金
国家自然科学基金项目（No.81672311）资助~~
关键词
肺肿瘤
TNM分期
预后
Lung neoplasms
TNM stage
Prognosis
