[1]李晓琪 梁智健 代孔旭 王鑫 张经纬 李晓**.手术切除小细胞肺癌生存预后分析及不同亚型生存比较[J].中国微创外科杂志,2023,01(6):409-415.
　Li Xiaoqi,Liang Zhijian,Dai Kongxu,et al.Survival Prognosis Analysis and Comparison of Surgically Resected Combined Small Cell Lung Cancer and Pure Small Cell Lung Cancer[J].Chinese Journal of Minimally Invasive Surgery,2023,01(6):409-415.
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手术切除小细胞肺癌生存预后分析及不同亚型生存比较()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年6期
页码:
409-415
栏目:
临床论著
出版日期:
2023-06-25

文章信息/Info

Title:
Survival Prognosis Analysis and Comparison of Surgically Resected Combined Small Cell Lung Cancer and Pure Small Cell Lung Cancer
作者:
李晓琪 梁智健 代孔旭 王鑫 张经纬 李晓**
(北京大学人民医院胸外科北京大学人民医院胸部肿瘤研究所，北京100044)
Author(s):
Li Xiaoqi;  Liang Zhijian;  Dai Kongxu;  et al.
Department of Thoracic Surgery, Thoracic Oncology Institute, Peking University People’s Hospital, Beijing 100044, China
关键词:
复合小细胞肺癌; 手术切除; 生存分析
Keywords:
Combined small cell lung cancer; Surgical resection; Survival analysis
文献标志码:
A
摘要:
目的分析手术切除小细胞肺癌(small cell lung cancer，SCLC)的生存预后，并对比复合小细胞肺癌(combined small cell lung cancer，cSCLC)与纯小细胞肺癌(pure small cell lung cancer，pSCLC)的生存预后差异。方法纳入2000年10月~2022年10月我科行根治性手术切除的SCLC患者，收集临床、手术和病理资料，采用单因素和多因素Cox回归分析影响手术切除SCLC患者生存预后的因素。KaplanMeier法计算总生存率(overall survival，OS)和无病生存率(diseasefree survival，DFS)，logrank检验进行生存曲线的对比。结果共纳入SCLC 138例，其中pSCLC 108例，cSCLC 30例。中位随访时间27.5月(4~164个月)。多因素Cox回归分析显示吸烟史和肿瘤TNM分期是手术切除SCLC的OS和DFS的独立预后因素(吸烟史OS HR=2.16，95% CI：1.17~4.01，P=0.014，DFS HR=208，95% CI：1.20~3.59，P=0.009；肿瘤TNM分期OS HR=3.59，95% CI：1.83~7.04，P<0.001，DFS HR=2.67，95% CI：1.47~4.88，P=0.001)，年龄是OS的独立预后因素(HR=1.86，95% CI：1.01~3.44，P=0.046)。cSCLC和pSCLC的5年OS率(49.1% vs.55.8%，P=0.921)和5年DFS率(41.6% vs.46.2%，P=0.612)均未见显著差异。在N0患者中，cSCLC和pSCLC的5年OS率和DFS率也未见显著差异，但在N12患者中，cSCLC的3年OS率和DFS率明显差于pSCLC(OS率220% vs.50.4%，logrank χ2=6.660，P=0010；DFS率10.4% vs.39.9%，logrank χ2=5.067，P=0.024)。结论手术切除SCLC的预后与吸烟史及肿瘤分期相关，手术切除的N0期cSCLC生存预后与pSCLC相似，但N12期cSCLC生存预后明显差于pSCLC。
Abstract:
ObjectiveTo investigate the prognosis of surgically resected small cell lung cancer (SCLC) and prognostic differences between surgically resected combined small cell lung cancer (cSCLC) and pure small cell lung cancer (pSCLC).MethodsPatients with SCLC who underwent radical surgical resection in our department from October 2000 to October 2022 were included, and their clinical, surgical, and pathological data were collected to analyze the factors affecting the survival prognosis of surgically resected SCLC by using univariate and multifactorial Cox regressions. The overall survival (OS) and diseasefree survival (DFS) rate were calculated, and the logrank test was performed for comparison of survival curves.Results A total of 138 cases of SCLC were included, including 108 cases of pSCLC and 30 cases of cSCLC. The median followup time was 27.5 months (range, 4-164 months). The multifactorial Cox regression analysis showed that smoking history and tumor TNM stage were independent prognostic factors for OS and DFS of surgically resected SCLC (smoking history: OS, HR=2.16, 95% CI: 1.17-4.01, P=0.014, DFS, HR=2.08, 95% CI: 1.20-3.59, P=0.009; TNM stage: OS, HR=3.59, 95% CI: 1.83-7.04, P<0.001, DFS, HR=2.67, 95% CI: 1.47-4.88, P=0.001), and the age was an independent prognostic factor only for OS (HR=1.86, 95% CI: 101-3.44, P=0.046). No significant differences were identified in 5year OS rate (49.1% vs. 55.8%, P=0.921) and 5year DFS rate (41.6% vs. 46.2%, P=0.612) for cSCLC and pSCLC. Among N0 patients, no significant differences were noted in 5year OS and DFS rates between cSCLC and pSCLC, but among N12 patients, 3year OS and DFS rates were significantly worse for cSCLC than that for pSCLC (OS rate: 22.0% vs. 50.4%, logrank χ2=6.660, P=0.010; DFS rate: 10.4% vs. 39.9%, logrank χ2=5.067, P=0.024).ConclusionsThe prognosis of surgically resected SCLC is related to smoking history and pathological stage. The prognosis of surgically resected cSCLC at N0 stage is similar to that of pSCLC, but cSCLC at N12 stage has significantly worse outcomes than pSCLC.

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备注/Memo

备注/Memo:
基金项目：北京大学百度基金(2020BD013)**通讯作者，Email：dr.lixiao@163.com
更新日期/Last Update: 2023-09-07