76例肺类癌的手术预后.docVIP

76例肺类癌的手术预后 　　[摘要] 目的 探讨原发性肺类癌的临床特征及手术治疗，并分析可能影响预后的因素。 方法 回顾性分析2005年3月～2015年1月于中国医科大学附属第一医院诊治的76例肺类癌的临床资料，对性别、年龄、吸烟史、肿瘤家族史、TNM分期、辅助化疗、病理分型等可能影响预后的因素进行单因素及多因素分析。 结果 76例病例总1、3、5、10年生存率分别为95.8%、83.4%、63.0%、45.6%，优于其他类型肺癌。单因素分析显示吸烟史（P = 0.000）、年龄（P = 0.005）、TNM分期（P = 0.000）、组织类型典型类癌/不典型类癌（TC/AC）（P = 0.008）、淋巴结转移（P = 0.017）以及术后化疗（P = 0.032）是影响肿瘤手术预后的因素。多因素分析显示TNM分期（OR = 3.406，95%CI：1.877～11.944，P = 0.001）以及病理分型（OR = 4.735，95%CI：1.276～9.095，P = 0.014）是影响手术预后情况的独立因素。 结论 肺类癌预后好于其他类型肺癌，根治性手术治疗是其主要的治疗手段。TNM分期及病理分型是手术预后的独立影响因素。 　　[关键词] 肺类癌；神经内分泌肿瘤；预后 　　[中图分类号] R734.2 [文献标识码] A [文章编号] 1673-7210（2016）03（b）-0096-04 　　[Abstract] Objective To explore the clinical features， surgical treatment and prognosis of pulmonary carcinoid tumors. Methods The clinical data of 76 patients with pulmonary carcinoid tumors in the First Affiliated Hospital of China Medical University， from March 2005 to January 2015， were retrospectively reviewed. Cox univariate and multivariate analysis was used to analyze the prognostic factors， including sex， age， smoking history， family history of tumor， TNM stage， adjuvant chemotherapy，histological type. Results The overall 1-， 3-， 5- and 10-year survival rates were 95.8%， 83.4%， 63.0% and 45.6% respectively， the prognosis of pulmonary carcinoid tumors was better than other types of lung cancer. Cox univariate analysis revealed that smoking history （P = 0.000）， age （P = 0.005）， TNM stage （P = 0.000）， histological type TC/AC （P = 0.008）， and lymph node metastasis （P = 0.017） were prognostic factors. Cox multivariate analysis exhibited that TNM stage （OR = 3.406， 95%CI： 1.877-11.944， P = 0.001） and histological type TC/AC （OR = 4.735， 95%CI：1.276-9.095， P = 0.014） were independent prognostic factors. Conclusion The prognosis of pulmonary carcinoid tumors is better than other types of lung cancer， the main treatment of pulmonary carcinoids is complete surgical resection. TNM stage and histological type are independent prognostic factors for pulmonary carc