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背景与目的肿瘤大小对预后的影响在肺癌的不同分期组间已明确,但其在同一分期中,尤其是直径小于3cm的肿瘤中对预后的影响尚未明确。本研究的目的是探讨ⅠA期非小细胞肺癌中肿瘤大小对预后的影响。方法回顾性分析自1995年1月至2003年12月我院胸外科手术治疗ⅠA期非小细胞肺癌142例,用Kaplan-Meier生存曲线统计不同肿瘤大小患者的生存率,并对发病年龄、性别、病理类型、肿瘤大小、手术方式以及是否接受放化疗等因素进行COX回归比例风险模型多因素分析。结果全组肿瘤直径≤2.0cm者60例,2.1~3.0cm者82例。全组3年、5年生存率分别为84.41%、70.89%,其中肿瘤直径≤2.0cm组分别为94.91%和81.40%,2.1~3.0cm组分别为82.18%和64.91%(P=0.0353)。单因素及多因素分析均显示,肿瘤大小为独立的预后因素。结论肿瘤大小是ⅠA期非小细胞肺癌的独立预后因素。临床工作中应进一步提高影像学诊断水平,使患者获得更早期的治疗。
BACKGROUND & OBJECTIVE: The effect of tumor size on prognosis has been clarified in different stages of lung cancer. However, its effect on prognosis in the same stage, especially in tumors less than 3 cm in diameter, has not yet been clarified. The purpose of this study was to investigate the effect of tumor size on prognosis in stage IA A non-small cell lung cancer. Methods A retrospective analysis of 142 patients with stage ⅠA non-small cell lung cancer from January 1995 to December 2003 in our hospital was performed. Survival rates of patients with different tumor sizes were calculated by Kaplan-Meier survival curve. The age, gender , Pathological type, tumor size, operation mode and whether to accept radiochemotherapy and other factors for multivariate analysis of COX regression proportional hazard model. Results There were 60 cases with diameter less than 2.0cm and 82 cases with 2.1 ~ 3.0cm in all groups. The 3-year and 5-year survival rates of the whole group were 84.41% and 70.89%, respectively, of which 94.91% and 81.40% in the tumor diameter ≤2.0cm group and 82.18% and 64.91% in the 2.1-3.0cm group respectively (P = 0.0353). Univariate and multivariate analysis showed that tumor size was an independent prognostic factor. Conclusions Tumor size is an independent prognostic factor for stage IA non-small cell lung cancer. Clinical work should further improve the diagnostic imaging level, so that patients receive an earlier treatment.