Background and objective More than 35%Ib stage lung cancers have metastasised or recurrenced atfer operation, whose prognosis still remain poor. hTere’re much controversy over the necessity of adjuvant chemotherapy to them. hTis aim of this study is investigated the clinical and pathological characters inlfuencing prognosis of the stage Ib non-small cell lung cancer (NSCLC) and to explore the indication of postoperative chemotherapy. Methods NSCLC patients (281 cases) who underwent lobectomy were examined. Cox proportional-hazards ratios were used to identify independent prognostic fac-tors for survival. Kaplan-Meier survival curves were calculated to estimate survival rates. Results Kaplan-Meier analysis show that, cancerous embolus in the blood vessel or lymphatic vessel, histologic grade and tumor location were remarkerbly associ-ated with mortality risk (P<0.05). hTe poor histologic grade and cancerous embolus in the blood vessel were closely associated with increased mortality risk on multivariate analysis in stage Ib NSCLC. Conclusion hTe low histologic grade and cancerous embolus in the blood vessel or lymphatic vessel are closely correlated with survival in the stage Ib NSCLC and can be an index for the postoperative chemotherapy.%背景与目的 Ib期肺癌患者术后2年内转移和复发率超过35%，预后仍较差，而该期患者术后是否需要辅助化疗依然存在争议。本探索研究影响早期非小细胞肺癌手术预后的相关临床病理学因素，探讨术后辅助化疗的高风险指征。方法281例接受完全性切除的Ib期非小细胞肺癌患者，依据Cox回归模型进行预后多因素分析，采用Kaplan-Meier方法进行生存分析。结果单因素分析显示：①存在淋巴管或血管内癌栓、低分化肿瘤、肿瘤位于中下叶者预后较差（P<0.05）；②患者的年龄、性别、病理类型、肿瘤侵犯胸膜、术后辅助化疗与术后生存无明显关系（P>0.05）。多因素分析显示：血管内癌栓和肿瘤低分化是影响患者生存率的主要因素。结论Ib期非小细胞肺癌患者肿瘤细胞分化程度及脉管内癌栓是影响手术预后及生存率的重要因素，低分化肿瘤和脉管癌栓可作为术后辅助化疗的指征之一。
展开▼
