Watanabe Katsuya, Sakamaki Kentaro, Ito Hiroyuki, Yokose Tomoyuki, Yamada Kozo, Nakayama Haruhiko, Masuda Munetaka
Department of General Thoracic Surgery, Yokohama Medical Center, Yokohama, Japan.
Department of General Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Eur J Cardiothorac Surg. 2020 Nov 1;58(5):1010-1018. doi: 10.1093/ejcts/ezaa138.
A micropapillary (MIP) component is reported to be associated with a poor prognosis in patients with completely resected lung adenocarcinoma. The purpose of this study was to investigate the impact of an MIP component on the timing of postoperative recurrence using hazard curves.
A total of 1289 patients with lung adenocarcinoma who underwent complete pulmonary resection from 2008 to 2015 were studied. Hazard curves representing the changes in hazard over time were evaluated.
The hazard curve displayed an initial wide, high peak within 1 year after surgery in patients with an MIP component, whereas some gentle peaks around the second year were noted in patients without an MIP component. The presence of an MIP component was associated with a worse recurrence-free survival and an early recurrence in stage I patients but not in advanced-stage patients. In multivariable Cox regression, the presence of an MIP component and lymph node metastasis, pleural invasion and gender were associated with a poor prognosis.
Patients with an MIP component retained a high risk of early recurrence after surgery, and the risk for recurrence persisted over the long term. Even after complete resection in stage I lung adenocarcinoma patients, an MIP component remains correlated with a poor prognosis.
据报道,微乳头(MIP)成分与完全切除的肺腺癌患者预后不良相关。本研究的目的是使用风险曲线研究MIP成分对术后复发时间的影响。
对2008年至2015年期间接受全肺切除的1289例肺腺癌患者进行了研究。评估了代表风险随时间变化的风险曲线。
MIP成分患者的风险曲线在术后1年内显示出初始宽而高的峰值,而无MIP成分的患者在第二年左右出现一些平缓的峰值。MIP成分的存在与I期患者较差的无复发生存率和早期复发相关,但与晚期患者无关。在多变量Cox回归中,MIP成分的存在、淋巴结转移、胸膜侵犯和性别与预后不良相关。
有MIP成分的患者术后仍有较高的早期复发风险,且复发风险长期存在。即使I期肺腺癌患者完全切除后,MIP成分仍与预后不良相关。