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肺腺鳞癌患者的临床病理特征及预后

Clinicopathological characteristics and prognosis of patients with adenosquamous lung carcinoma.

作者信息

Guo Ye, Jia Lin, Shao Guo-Guang, Sun Hong-Wei, Wang Xing-Xing, Wang Guan-Jun, Ma Ke-Wei

机构信息

Department of Oncology, The First Hospital of Jilin University, Changchun, 130021, China.

Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, 130021, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2015 Jun;35(3):350-355. doi: 10.1007/s11596-015-1436-z. Epub 2015 Jun 14.

Abstract

This study was aimed to characterize clinicopathological features and prognosis of patients with adenosquamous lung carcinoma (ASC). Among the 2531 patients with lung cancer who underwent surgery between January 2000 and June 2012 in our hospital, 59 were histologically diagnosed as having ASC. The clinicopathological features and follow-up data of ASC patients were collected and analyzed statistically. Superior lobectomy was accomplished in 40 patients, middle and inferior lobectomy in 3, lobectomy plus partial resection of contralateral lung in 5, partial lung resection in 4, and pneumonectomy in 7. Moreover, 22 cases were found to be adenocarcinoma-predominant, and 18 to be squamous cell carcinoma-predominant. The median survival time was 13.6 months, and the 1-, 3-, and 5-year survival rates were 59.9%, 36.4% and 31.2%, respectively. Of the 52 cases with tissue specimens available, 11 had an EGFR mutation (21.2%) and 2 had a KRAS mutation (3.8%). Multivariate analysis showed that histology subtype, pleural invasion, TNM stage, and postoperative treatment were all independent prognostic factors. The data from the current study demonstrated that SCC-predominant histology represents a better prognosis of ASC. Histology subtype, pleural invasion, TNM stage, and postoperative treatment are independent prognostic factors for ASC and adjuvant therapy may help control the disease.

摘要

本研究旨在描述肺腺鳞癌(ASC)患者的临床病理特征及预后。在2000年1月至2012年6月间于我院接受手术的2531例肺癌患者中,59例经组织学诊断为ASC。收集并对ASC患者的临床病理特征及随访数据进行统计学分析。40例行上叶切除术,3例行中叶及下叶切除术,5例行肺叶切除术加对侧肺部分切除术,4例行肺部分切除术,7例行全肺切除术。此外,发现22例以腺癌为主,18例以鳞状细胞癌为主。中位生存时间为13.6个月,1年、3年和5年生存率分别为59.9%、36.4%和31.2%。在52例有组织标本的病例中,11例存在表皮生长因子受体(EGFR)突变(21.2%),2例存在KRAS突变(3.8%)。多因素分析显示,组织学亚型、胸膜侵犯、TNM分期及术后治疗均为独立的预后因素。本研究数据表明,以鳞状细胞癌为主的组织学类型代表ASC预后较好。组织学亚型、胸膜侵犯、TNM分期及术后治疗是ASC的独立预后因素,辅助治疗可能有助于控制疾病。

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