Kita H, Koshiishi Y, Masui K, Fujita A, Ootsuka K, Furuyashiki G, Nakazato Y, Takei H, Goya T
Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan.
Kyobu Geka. 2007 Sep;60(10):883-7.
We reviewed risk factors of recurrence in resected pathological stage I non-small cell lung cancer (I NSCLC). Objective is 229 complete resected I NSCLC in our department. Risk factors of recurrence were carcinoembryonic antigen (CEA), histology, differentiation, lymphatic invasion, blood vessel invasion, pleural invasion and tumor size. By univariate analysis, lymphatic invasion (p=0.009), blood vessel invasion (p=0.008), pleural invasion, p1 (p=0.013), p2 (p=0.001), and tumor size (value of cut off was 2 cm) were significant risk factors of recurrence. By multivariate analysis, blood vessel invasion (p=0.004), pleural invasion (p1 or p2) [p=0.001], were significantly risk factors of recurrence. It was suggested that I NSCLC presenting pathological blood vessel invasion and/or pleural invasion should be recognized as cases with a high risk of recurrence, and a strict follow-up and adjuvant therapy should be in consideration.
我们回顾了接受手术切除的病理I期非小细胞肺癌(I期NSCLC)的复发危险因素。研究对象为我院229例接受了完整切除的I期NSCLC患者。复发的危险因素包括癌胚抗原(CEA)、组织学类型、分化程度、淋巴管侵犯、血管侵犯、胸膜侵犯和肿瘤大小。单因素分析显示,淋巴管侵犯(p=0.009)、血管侵犯(p=0.008)、胸膜侵犯、p1(p=0.013)、p2(p=0.001)以及肿瘤大小(截断值为2 cm)是复发的显著危险因素。多因素分析显示,血管侵犯(p=0.004)、胸膜侵犯(p1或p2)[p=0.001]是复发的显著危险因素。提示病理上存在血管侵犯和/或胸膜侵犯的I期NSCLC应被视为复发高危病例,需考虑进行严格的随访和辅助治疗。