组织学分级：完全切除术后非小细胞肺癌的预后分析
Histological Grade: Analysis of Prognosis of Non-small Cell Lung Cancer After Complete Resection.
作者信息
Yasukawa Motoaki, Sawabata Noriyoshi, Kawaguchi Takeshi, Kawai Norikazu, Nakai Tokiko, Ohbayashi Chiho, Taniguchi Shigeki
机构信息
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan
Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, Kashihara, Japan.
出版信息
In Vivo. 2018 Nov-Dec;32(6):1505-1512. doi: 10.21873/invivo.11407.
BACKGROUND/AIM: Although the 2015 World Health Organization Classification reported that histological grading may be helpful in lung cancer management, a widely accepted histological grading system with clearly defined criteria and demonstrable clinical significance has not been developed. We investigated the prognoses of patients with resected non-small cell lung cancer (NSCLC) to identify prognostic factors, especially histological grade.
MATERIALS AND METHODS
The medical records of 531 patients between 2010 and 2015 were retrospectively reviewed. Overall survival (OS) curve was plotted using the Kaplan-Meier method. Cox regression analyses were used to evaluate the hazard ratio (HR) with endpoint of OS.
RESULTS
The 5-year OS rate in groups with histological grade 1, grade 2, and grade 3+4 groups was 95.8%, 85.7%, and 72.1%, respectively (p<0.001). Multivariate analysis identified histological grade and vascular invasion as independent predictors of OS [histological grade: HR=1.533, p=0.002].
CONCLUSION
Histological grade was an independent prognostic factor of patients resected for all stages of NSCLC.
背景/目的：尽管2015年世界卫生组织分类报告指出组织学分级可能有助于肺癌管理，但尚未建立一个具有明确标准和可证明临床意义的广泛接受的组织学分级系统。我们研究了接受手术切除的非小细胞肺癌（NSCLC）患者的预后，以确定预后因素，尤其是组织学分级。
材料与方法
回顾性分析2010年至2015年间531例患者的病历。采用Kaplan-Meier法绘制总生存（OS）曲线。采用Cox回归分析评估以OS为终点的风险比（HR）。
结果
组织学1级、2级和3 + 4级组的5年OS率分别为95.8%、85.7%和72.1%（p<0.001）。多因素分析确定组织学分级和血管侵犯为OS的独立预测因素[组织学分级：HR = 1.533，p = 0.002]。
结论
组织学分级是各期NSCLC手术切除患者的独立预后因素。
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