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肺腺癌完全切除术后患者术后早期复发预后因素的临床研究

A clinical study of the prognostic factors for postoperative early recurrence in patients who underwent complete resection for pulmonary adenocarcinoma.

作者信息

Sakai Takehiro, Tsushima Takao, Kimura Daisuke, Hatanaka Ryo, Yamada Yoshitsugu, Fukuda Ikuo

机构信息

Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2011;17(6):539-43. doi: 10.5761/atcs.oa.11.01660. Epub 2011 Jul 27.

DOI:10.5761/atcs.oa.11.01660
PMID:21881354
Abstract

PURPOSE

The 2-[F-18]-Fluoro-2-deoxy-D-glucose (FDG) uptake in positron emission tomography (PET) and serum neutrophil/lymphocyte ratio (NLR) are recently noteworthy prognostic factors. We studied the prognostic factor to predict early recurrence after curative resection for pulmonary adenocarcinoma including FDG uptake and NLR.

METHODS

We performed a retrospective review of 23 patients who underwent a complete resection for pulmonary adenocarcinoma. The patients were divided into 2 groups: 19 patients in the disease-free group, and 4 patients in the recurrent group. Clinical and pathological factors concerning the recurrence within 1 year of surgery were analyzed between two groups.

RESULTS

No significant differences between the recurrent group and disease-free group was seen in age, gender, CEA, NLR, CRP, pathological stage, pleural invasion, pathological grading, Ki-67 expression, venous invasion and lymphatic invasion. The SUVmax was significantly elevated in the recurrent group (12.5 ± 2.01 vs. 5.70 ± 3.97, p = 0.0094). Tumor size was significantly larger in the recurrent group (5.58 ± 0.71 vs. 3.62 ± 1.33 cm, p = 0.0058). The first, recurrent sites in 4 patients were brain, in 3 patients; and lung, in 1 patient.

CONCLUSION

Both tumor size and SUVmax are possible predictors of early recurrence after curative resection in patients with pulmonary adenocarcinoma. Although it is impossible to determine the SUVmax as an independent prognostic factor, the SUVmax may be one of the predictors of early hematogenous recurrence in surgically treated pulmonary adenocarcinoma.

摘要

目的

正电子发射断层扫描(PET)中的2-[F-18]-氟-2-脱氧-D-葡萄糖(FDG)摄取以及血清中性粒细胞/淋巴细胞比值(NLR)是近期值得关注的预后因素。我们研究了包括FDG摄取和NLR在内的预测肺腺癌根治性切除术后早期复发的预后因素。

方法

我们对23例行肺腺癌根治性切除术的患者进行了回顾性研究。患者分为两组:无病组19例,复发组4例。分析两组之间与术后1年内复发相关的临床和病理因素。

结果

复发组与无病组在年龄、性别、癌胚抗原(CEA)、NLR、C反应蛋白(CRP)、病理分期、胸膜侵犯、病理分级、Ki-67表达、静脉侵犯和淋巴侵犯方面均无显著差异。复发组的最大标准化摄取值(SUVmax)显著升高(12.5±2.01对5.70±3.97,p = 0.0094)。复发组的肿瘤大小显著更大(5.58±0.71对3.62±1.33 cm,p = 0.0058)。4例患者的首次复发部位,3例为脑,1例为肺。

结论

肿瘤大小和SUVmax均可能是肺腺癌患者根治性切除术后早期复发的预测指标。虽然无法将SUVmax确定为独立的预后因素,但SUVmax可能是手术治疗的肺腺癌早期血行复发的预测指标之一。

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