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I期非小细胞肺癌患者淋巴管侵犯的临床意义

Clinical significance of lymphatic vessel invasion in stage I non-small cell lung cancer patients.

作者信息

Ma K F, Chu X Y, Liu Y

机构信息

Department of Thoracic Surgery, General Hospital of the People's Liberation Army, Beijing, China.

Department of Thoracic Surgery, General Hospital of the People's Liberation Army, Beijing, China

出版信息

Genet Mol Res. 2015 Mar 13;14(1):1819-27. doi: 10.4238/2015.March.13.10.

Abstract

The aim of this retrospective study was to evaluate the prognostic influence of lymphatic vessel invasion (LVI) in stage I non-small cell lung cancer (NSCLC) patients. From January 2004 to December 2007, LVI was detected in 57 patients with T1N0M0 NSCLC; therefore, 114 patients with the same pathology, T stage, and surgery method, but without LVI, were selected as the control group to compare survival. The overall survival and relapse-free survival rates were estimated using the Kaplan-Meier method, log-rank test, and Cox proportional hazards analysis. The average follow-up length was 59.94 ± 23.1 months. The 5-year overall survival rates of the LVI-negative and the LVI-positive groups were 90.54 and 70.1%, respectively (P = 0.002). A multivariate analysis revealed LVI to be an independent predictive factor (hazard ratio = 4.562; P = 0.004). The 5-year overall survival rates for patients who received postoperative adjunctive therapy and those who did not in the LVI-positive group were 88.2 and 61.5%, respectively, with a P value less than 0.05 in both univariate and multivariate analyses. LVI is a poor prognostic factor in stage I NSCLC patients; postoperative adjunctive therapy is needed to improve the prognosis of NSCLC patients with LVI.

摘要

这项回顾性研究的目的是评估淋巴管侵犯(LVI)对Ⅰ期非小细胞肺癌(NSCLC)患者预后的影响。2004年1月至2007年12月期间,在57例T1N0M0 NSCLC患者中检测到LVI;因此,选择114例具有相同病理、T分期和手术方式但无LVI的患者作为对照组比较生存率。采用Kaplan-Meier法、对数秩检验和Cox比例风险分析评估总生存率和无复发生存率。平均随访时间为59.94±23.1个月。LVI阴性组和LVI阳性组的5年总生存率分别为90.54%和70.1%(P = 0.002)。多因素分析显示LVI是一个独立的预测因素(风险比=4.562;P = 0.004)。LVI阳性组中接受术后辅助治疗和未接受术后辅助治疗的患者5年总生存率分别为88.2%和61.5%,单因素和多因素分析的P值均小于0.05。LVI是Ⅰ期NSCLC患者的不良预后因素;需要术后辅助治疗以改善LVI NSCLC患者的预后。

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