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目的分析原发灶不明的淋巴结转移癌的临床特点,探讨其治疗方法及预后。方法回顾性分析我院2002年1月至2008年1月收治的31例原发灶不明的淋巴结转移癌患者的临床资料。结果全组的中位生存期为0.94年(0.28～6.20年)。单因素分析结果显示,分期、LDH、WBC、NSE和腺癌相关肿瘤标志物增高是预后不良的相关因素(P<0.05),根据这些预后不良因素建立预后指数评分,0分、1～2分、≥3分患者的1年生存率分别为100.00%、53.72%和16.67%(χ2=18.98,P=0.0001)。化疗后评价为部分缓解、稳定、进展患者的1年生存率分别为82.96%、41.67%和25.00%(χ2=6.21,P=0.0448)。结论原发灶不明的淋巴结转移癌患者的预后较差,根据预后影响因素建立预后评分可以预测患者的预后,提高化疗的疗效是改善预后的重要手段。
Objective To analyze the clinical features of lymph node metastasis of unknown primary tumor and discuss its treatment and prognosis. Methods The clinical data of 31 patients with unknown primary lymph node metastasis admitted from January 2002 to January 2008 in our hospital were retrospectively analyzed. Results The median survival of the whole group was 0.94 years (0.28 ~ 6.2.20 years). Univariate analysis showed that staging, LDH, WBC, NSE, and adenocarcinoma-associated tumor markers were associated with poor prognosis (P <0.05). Prognostic index scores were scored according to these adverse prognostic factors, 0, 1 to 2 The 1-year survival rates of patients with ≥3 points were 100.00%, 53.72% and 16.67%, respectively (χ2 = 18.98, P = 0.0001). The 1-year survival rates of patients who were evaluated as partially relieved, stable, and progressed after chemotherapy were 82.96%, 41.67%, and 25.00%, respectively (χ2 = 6.21, P = 0.0448). Conclusion The prognosis of patients with lymph node metastasis of unknown primary tumor is poor. Establishing the prognostic score according to prognostic factors can predict the prognosis of patients and improve the curative effect of chemotherapy is an important means to improve prognosis.