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非小细胞肺癌患者术前阶段及手术结果评估

Evaluation of the preoperative stage and operative findings in patients with non-small cell lung cancer.

作者信息

Hadzismailović Ademir, Pilav Alen

机构信息

Clinic for Thoracic Surgery, University of Sarajevo Clinics Centre, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina.

出版信息

Bosn J Basic Med Sci. 2007 Aug;7(3):239-44. doi: 10.17305/bjbms.2007.3052.

Abstract

Lung cancer is responsible for 40% mortalities from malignant diseases in man and exhibits an extremely infiltrating way of growing. It does not respect the lobes' or the organs' borders and spreads by blood system, lymph system and per continuitatem. According to its biological characteristics and response to treatments it may be divided in to small cell lung cancer (SCLC) and non small cell lung cancer (NSCLC), which also includes other histological types. Lung cancer treatment includes surgical treatment, chemotherapy, radiotherapy, the combination of the former three as well as symptomatic treatment. In this study, we analyzed 125 patients with lung cancer, that were hospitalized at the Clinic for Thoracic Surgery in KCU Sarajevo. The difference according to gender is statistically significant because we had 111 (88,8%) male patients in comparison with 14 (11,2%) female patients. The average age of male patients was 60,3 years while female patients were 61,9 years old on average. Thus, the difference in average age is not statistically significant. In diagnostic procedures: chest radiography was the most significant in peripheral lesions (60, 8%). CT of the thoracic organs has a statistical significance because the tumor changes were confirmed in 123 patients (98,4%). In bronchoscopy, we had 120 patients (96,0%). The number of patients with preformed lobectomy (63) is statistically significantly greater in the observed group (125) then the number of patients with other operative procedures preformed. From the postoperative complications we had exitus letalis 2 (1,6%), wound infection 19 (15,2%), and 104 without complications (83,2%). The results of testing the significance of differences according to the cancer types in non small cell lung cancer were planocellular, adenocarcinoma, and macrocellular. Comparing the preoperative staging and operative findings through stages we obtained to the following results: in stage ST0 the deviation was 16,7%, STIA the deviation was 40,1%, STIB the deviation was 16,1%, STIIA the deviation was 11,1%, STIIB the deviation was 12,5%, STIIIA the deviation was 33,33%, STIIIB the deviation was 33, 3%. From the overall number of patients, who were in preoperatively graded stage STIA, operative findings confirmed STIA, which makes the most important statistically significant difference. In 36 patients or 28,8% the status was changed in operative finding. In 89 patients preoperative status or 72,2% remained unchanged following the operation.

摘要

肺癌导致人类40%的恶性疾病死亡,其生长方式具有极强的浸润性。它不受肺叶或器官边界的限制,通过血液系统、淋巴系统和连续性播散。根据其生物学特性和对治疗的反应,可分为小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC),后者还包括其他组织学类型。肺癌治疗包括手术治疗、化疗、放疗、前三者联合以及对症治疗。在本研究中,我们分析了125例在萨拉热窝KCU胸外科住院的肺癌患者。根据性别差异具有统计学意义,因为我们有111例(88.8%)男性患者,而女性患者为14例(11.2%)。男性患者的平均年龄为60.3岁,而女性患者平均年龄为61.9岁。因此,平均年龄差异无统计学意义。在诊断程序方面:胸部X线摄影对周围病变最为重要(60.8%)。胸部器官CT具有统计学意义,因为在123例患者(98.4%)中证实了肿瘤变化。在支气管镜检查中,我们有120例患者(96.0%)。在观察组(125例)中,进行肺叶切除术的患者数量(63例)在统计学上显著多于进行其他手术的患者数量。术后并发症方面,有2例(1.6%)死亡,19例(15.2%)伤口感染,104例(83.2%)无并发症。对非小细胞肺癌中不同癌症类型差异的显著性进行检测的结果为扁平细胞癌、腺癌和大细胞癌。通过分期比较术前分期和手术结果,我们得到以下结果:在ST0期偏差为16.7%,STIA期偏差为40.1%,STIB期偏差为16.1%,STIIA期偏差为11.1%,STIIB期偏差为12.5%,STIIIA期偏差为33.33%,STIIIB期偏差为33.3%。在术前分级为STIA期的患者总数中,手术结果证实为STIA期,这在统计学上是最重要的显著差异。在36例患者(28.8%)中,手术结果改变了病情状态。在89例患者(72.2%)中,术后术前状态未改变。

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