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我院自1960年至1983年24年间住院手术治疗非小细胞肺癌276例,其中鳞癌134例(48.6％),腺癌100例(36.2%)、大细胞癌20例(7.2%)、腺鳞癌3例(1.1％)和未定型癌19例(6.9%)。手术切除180例(包括6例死亡),切除率为65.2％。根治性切除163例中Ⅰ期114例(70％)、Ⅱ期42例(25.7％)和Ⅲ期7例(4.3％)。能评价疗效者157例,其5年生存率为42.5％,10年生存率29.4％。淋巴结无转移的5年生存率为47％,10年为35.4％;有转移的5年生存率为29.4%,10年为15％。Ⅰ期的5年生存率为48.4％,Ⅱ期为23.3％。不同病理类型的预后有较大区别,本组鳞癌的预后优于腺癌。癌瘤位于上叶或下叶对预后影响不明显,以中叶肺癌的预后为最差,手术标本支气管断端肉眼所见正常,但並微镜下见癌细胞者12例,半数术后良好,死于癌者亦未见残端复发癌。
In our hospital from 1960 to 1983, we treated 276 patients with NSCLC, including 134 (48.6%) of squamous cell carcinomas, 100 (36.2%) of adenocarcinomas, 20 (7.2%) of large cell carcinomas, and glands. There were 3 cases of squamous cell carcinoma (1.1%) and 19 cases of unfixed carcinoma (6.9%). 180 cases (including 6 deaths) were resected and the resection rate was 65.2%. Of the 163 patients undergoing radical resection, 114 (70%) were in phase I, 42 (25.7%) were in phase II, and 7 (4.3%) were in phase III. Among the 157 patients who could evaluate the efficacy, the 5-year survival rate was 42.5%, and the 10-year survival rate was 29.4%. The 5-year survival rate for lymph node metastasis was 47%, 35.4% for 10 years; the 5-year survival rate for metastasis was 29.4%, and 15% for 10 years. The 5-year survival rate at stage I was 48.4%, and stage 2 was 23.3%. The prognosis of different pathological types is quite different. The prognosis of squamous cell carcinoma in this group is better than that of adenocarcinoma. The upper or lower lobe had no significant effect on prognosis. The prognosis of lung cancer in the middle lobe was the worst. The bronchial stump of the surgical specimen was normal to the naked eye. However, 12 cases were seen under the microscopic microscope. Half of the patients had good postoperative disease. Those who died of cancer did not have stump cancer.