Gao Yu-Shun, Zhang De-Chao, He Jie, Sun Ke-Lin, Zhang Da-Wei, Zhang Ru-Gang
Department of Thoracic Surgical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
Zhonghua Zhong Liu Za Zhi. 2005 Jan;27(1):52-5.
To evaluate the results of surgery and the diagnosis of stage I non-small-cell lung cancer (NSCLC).
The survival of 274 stage I NSCLC patients who underwent surgery from 1991 to 1998 were statistically analyzed by the Kaplan-Meier method. Comparison of the differences in survival rates among groups were made according to the Logrank test. The follow-up time was at least 5 years with a follow-up rate of 97.8%.
The overall 1-, 3-, 5-year survival rates for patients with pathologic stage I lesion were 92.9%, 79.6% and 66.1%. The 5-year survival rates for patients with squamous-cell carcinoma, adenocarcinoma, adenosquamous and alveolar-cell carcinoma were 73.3%, 55.3%, 52.2%, 71.7%, respectively. The 1-, 3-, 5-year survival rates for T1N0 were 95.0%, 83.2%, 74.3% whereas those of T2N0 lung lesions were 90.8%, 75.9%, 59.9% (P < 0.05). The 1-, 3-, 5-year survival rates of regular lobectomy were 94.1%, 79.3%, 67.5% and of conservative resection (segmentectomy and wedge resection) were 76.5%, 50.0%, 38.3% (P < 0.05). There was no perioperative mortality. The postoperative complications were: intrathoracic hemorrhage (2 patients, successfully treated by second thoracotomy) and chylothorax (1 patient, healed after conservative treatment).
The 5-year survival rate of pathologic stage I non-small-cell lung cancer is 66.1%. The outcome of patients with squamous-cell carcinoma (73.3%) is similar to that of alveolar-cell carcinoma (71.7%) which, however, is better than that of adenocarcinoma (55.3%) or adenosquamouscarcinoma (52.5%). The overwhelming superiority in result of IA (T1N0) lesion (74.3%) over the IB (T2N0) disease (59.9%) is quite impressive. Regular lobectomy plus radical mediastinal lymph node dissection is the appropriate management for stage I non-small-cell lung cancer.
评估I期非小细胞肺癌（NSCLC）的手术结果及诊断情况。
采用Kaplan-Meier法对1991年至1998年接受手术的274例I期NSCLC患者的生存情况进行统计学分析。根据Logrank检验比较各组生存率的差异。随访时间至少5年，随访率为97.8%。
病理I期病变患者的1年、3年、5年总生存率分别为92.9%、79.6%和66.1%。鳞状细胞癌、腺癌、腺鳞癌和肺泡细胞癌患者的5年生存率分别为73.3%、55.3%、52.2%、71.7%。T1N0患者的1年、3年、5年生存率分别为95.0%、83.2%、74.3%，而T2N0肺部病变患者的生存率分别为90.8%、75.9%、59.9%（P<0.05）。常规肺叶切除术的1年、3年、5年生存率分别为94.1%、79.3%、67.5%，保守性切除术（肺段切除术和楔形切除术）的生存率分别为76.5%、50.0%、38.3%（P<0.05）。无围手术期死亡。术后并发症有：胸腔内出血（2例，经二次开胸成功治疗）和乳糜胸（1例，保守治疗后痊愈）。
病理I期非小细胞肺癌的5年生存率为66.1%。鳞状细胞癌患者（73.3%）的预后与肺泡细胞癌患者（71.7%）相似，但优于腺癌患者（55.3%）或腺鳞癌患者（52.5%）。IA期（T1N0）病变（74.3%）的结果相对于IB期（T2N0）疾病（59.9%）具有压倒性优势，令人印象深刻。常规肺叶切除术加根治性纵隔淋巴结清扫术是I期非小细胞肺癌的合适治疗方法。
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