贵州医科大学学报

2007, No.128(05) 474-477

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区域淋巴结微小转移对非小细胞肺癌长期生存的影响
The Influence of Micrometastases of Regiondal Lymph Nodes on the Survival of Patients with Non-Small Cell Lung Cancer

欧阳伟炜;卢冰;周华宁;何常;龙义国;王平;
OUYANG Weiwei1,LU Bing1,ZHOU Huanin1,HE Chang2,LONG Yiguo2,WANG Ping1(1.Department of Oncology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China;2.Department of Pathology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China)

摘要(Abstract):

目的:检测非小细胞肺癌(NSCLC)根治术后常规病理诊断无转移的区域淋巴结中的微小转移,研究微小转移对预后的影响。方法:收集根治术后常规病理证实为T1-4N0-1M0的107例NSCLC的肺门及纵隔淋巴结蜡块,采用Envision二步法检测。结果:NSCLC中微小转移检出率为29.9%。非微小转移病例的1、3、5年生存率及中位生存期较微小转移病例明显延长(均P<0.05)。Cox回归显示KPS评分、CK、T分期及病理分级是影响生存期的独立因素(均P<0.05)。术后放化疗与单纯手术比较术后放化疗组长期生存有优势,但无统计学意义(P>0.05)。结论:NSCLC淋巴结微小转移是影响长期生存的不利因素,放化疗干预有可能延长生存。
Objective: To detect the micrometastases in lymph nodes at pathologically affirmed non-metastasis area of non-small-cell lung cancer(NSCLC) after radical correction,and to study its influence on the prognosis of the disease.Methods: Paraffin-embedded specimens of hilum and mediastinal lymph node of T1-4N0-1M0 in 107 cases of pathologically affirmed NSCLC patients were collected,and the micrometastasis in them was detected with EnVision method.Results: The total positive rate of micrometastasis in patients was 29.9%.The 1-,3-,and 5-year survival rates and median survival time of non-micrometastasis group were significantly higher than those of micrometastasis group(P<0.05).Cox regression prognostic analysis showed that KPS scores,and pathological grade CK,and T were independent predictors of overall survival(P<0.05).Postoperative radiochemotherapy showed more advantage than surgery only,but no statistical significance was found(P>0.05).Conclusions: Micrometastasis is a disadvantageous factor to survival of patients with NSCLC,and intervention of radiotherapy and chemotherapy could extend patient's life.

关键词(KeyWords): 癌,非小细胞肺;放射疗法;药物疗法;肿瘤转移;细胞角蛋白;微小转移;生存率
carcinoma,non-small-cell lung;radiotherapy;drug therapy;neoplasm metastasis;cytokeratin;micrometastasis;survival rate

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生厅资助项目(编号:G2004-12)

作者(Author): 欧阳伟炜;卢冰;周华宁;何常;龙义国;王平;
OUYANG Weiwei1,LU Bing1,ZHOU Huanin1,HE Chang2,LONG Yiguo2,WANG Ping1(1.Department of Oncology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China;2.Department of Pathology,The Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China)

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DOI: 10.19367/j.cnki.1000-2707.2007.05.009

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