可切除的肺浸润性黏液腺癌的临床特点和预后分析
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国家自然科学基金青年项目(81902453)


Clinical features and prognosis of resectable invasive mucinous adenocarcinoma of the lung
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    目的:探讨肺浸润性黏液腺癌(invasive mucinous adenocarcinoma,IMA)的临床病理特点及其预后相关因素。方法:回顾性分析2015年1月—2019年12月在南京医科大学第一附属医院行根治性手术治疗且术后病理明确诊断为IMA的106例患者的临床病理特点,通过Kaplan-Meier法及时序检验计算总体生存率和无病生存率,同时生成生存曲线。结果:14例患者术前CT影像上表现为肺炎型。所有患者均接受根治性手术治疗,50例患者接受了术后辅助治疗。单因素生存分析显示,肺炎型表现、T分期与淋巴结转移及是否行辅助治疗是影响IMA患者术后总体生存率的因素(P < 0.05)。此外,肺炎型表现、T分期、淋巴结转移、手术方式及是否行辅助治疗等与患者术后无病生存率相关(P < 0.05)。Cox风险评估模型多因素生存分析显示,肺炎型表现及淋巴结转移是影响IMA患者术后总体生存率和无病生存率的独立危险因素(P < 0.05)。结论:肺炎型表现以及淋巴结转移与肺IMA的不良预后相关。

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    Objective: To investigate the clinicopathological features and prognostic factors of invasive mucinous adenocarcinoma (IMA)of the lung. Methods:From January 2015 to December 2019,106 patients were identified as having IMA accepted radical resection and enrolled in the retrospective study. Their clinicopathological features were analyzed,the overall survival rate and disease-free survival rate were calculated by Kaplan-Meier and log-rank test,and the survival curve was generated. Results:On preoperative CT images, 14 patients showed pneumonia. All patients received radical surgery,and 50 patients received postoperative adjuvant therapy. Univariate survival analysis showed that pneumonia type,T stage,lymph node metastasis and whether adjuvant treatment were the factors affecting the overall survival rate of IMA patients(P < 0.05). In addition, the expression of pneumonia,T stage,lymph node metastasis,operation method and whether adjuvant treatment were related to the disease-free survival rate(P < 0.05). Multivariate survival analysis of Cox risk assessment model showed that pneumonia and lymph node metastasis were independent risk factors affecting the overall survival rate and disease-free survival rate of IMA patients(P < 0.05). Conclusion:The manifestation of pneumonia and lymph node metastasis are associated with the poor prognosis of IMA.

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孙 伟,于 跃,李 俊,葛 飒,张朋朋,王 伟.可切除的肺浸润性黏液腺癌的临床特点和预后分析[J].南京医科大学学报(自然科学版),2022,42(4):549-555

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  • 收稿日期:2021-11-16
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  • 在线发布日期: 2022-04-25
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