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目的分析术后病理Ⅰ_A期非小细胞肺癌患者的临床病理特征,探讨影响其预后的危险因素。方法回顾性分析我科1993年1月至2012年12月术后病理证实为Ⅰ_A期的非小细胞肺癌患者138例的临床资料,其中男81例、女57例,年龄37~80岁,中位年龄61岁。收集相关住院临床资料和随访资料。绘制Kaplan-Meier生存曲线,采用Cox比例风险模型进行单因素和多因素分析,评价各因素对无病生存的影响。结果随访时间9~90个月,中位随访时间为59个月。随访过程中患者出现复发转移14例(10.1%),局部复发8例,同时发现骨转移和同侧肺门淋巴结增大1例。单因素分析显示脉管浸润(P=0.017)、病理低分化(P=0.043)、肿瘤直径≥2 cm(T1b,P=0.017)是预后不良的危险因素。多因素分析表明脉管侵犯(P=0.011)和肿瘤的直径≥2 cm(T1b,P=0.026)是Ⅰ_A期非小细胞肺癌患者预后不良的独立危险因素。结论脉管浸润和肿瘤直径是Ⅰ_A期非小细胞肺癌患者预后的独立危险因素。
Objective To analyze the clinicopathological features of patients with stage Ⅰ-A non-small cell lung cancer and to explore the risk factors influencing their prognosis. Methods The clinical data of 138 patients with non-small cell lung cancer who were confirmed as stage Ⅰ-A from January 1993 to December 2012 in our department were retrospectively analyzed. There were 81 males and 57 females, aged 37 to 80 years Age 61 years old. Relevant hospitalized clinical data and follow-up data were collected. Kaplan-Meier survival curves were drawn and univariate and multivariate analyzes were performed using the Cox proportional hazards model to assess the impact of various factors on disease-free survival. Results The follow-up time ranged from 9 to 90 months. The median follow-up time was 59 months. During follow-up, 14 cases (10.1%) had recurrence and metastasis, and 8 cases had local recurrence. One case of bone metastasis and ipsilateral hilar lymph node enlargement was also found. Univariate analysis showed that vascular invasion (P = 0.017), poorly differentiated pathology (P = 0.043) and tumor diameter ≥2 cm (T1b, P = 0.017) were risk factors for poor prognosis. Multivariate analysis showed that vascular invasion (P = 0.011) and tumor diameter ≥2 cm (T1b, P = 0.026) were independent risk factors for poor prognosis in patients with stage I_A non-small cell lung cancer. Conclusion Vascular invasion and tumor diameter are independent risk factors for the prognosis of patients with stage Ⅰ_A non-small cell lung cancer.