肺腺鳞癌预后影响因素分析及治疗方式探讨

摘要

目的：探讨Ⅰ－IV 期肺腺鳞癌患者的预后及其影响因素。方法：回顾性分析2002年1月至2012年12月四川省肿瘤医院收治肺腺鳞癌患者的临床资料，对影响其预后的各因素进行了单因素及多因素分析。结果：全组患者1、3、5年生存率分别为62．5％、31．2％和10．4％，中位生存期为21．0个月。单因素分析显示I －II 期患者术后进行了辅助化疗与术后未进行辅助化疗的 PFS 及 OS 比较，没有显示出进行辅助化疗与生存之间有相关性。而对于进行了手术及术后辅助治疗的不同分期的患者，I －II 期的患者较 III 期的患者显示出生存获益（P ＝0．057）。而 III 期的术后患者术后辅助化疗是影响预后的重要因素（P ＜0．05）。对于局部晚期无法手术的患者和晚期的患者，在治疗中有无联合放疗、中位生存时间没有差异性。多因素分析也更进一步证实分期为影响腺鳞癌预后的独立预后因素。结论：肺腺鳞癌整体预后差。是否进行手术、术后治疗和患者分期是其预后相关因素。Ⅲ期肺腺鳞癌患者可从术后辅助化疗中获益。%Objective:To investigate the prognostic factors in the stage Ⅰ to stage IV adenosquamous lung carci-noma,and its influencing factors.Methods:Clinical data of patients diagnosed with adenosquamous lung carcinoma af-fecting prognosis was evaluated using univariate and multivariate analyses.Results:The 1,3 and 5 -year survival rates were 62.5%,31.2% and 10.4%,respectively,and the median survival time was 21.0 months.Single factor a-nalysis showed that the I -II patients whether performed postoperative adjuvant chemotherapy,PFS and OS had no correlation.For surgery and postoperative adjuvant therapy in patients with different stages,early stage patients showed a survival benefit(P =0.057).Postoperative adjuvant chemotherapy in stage Ⅲ patients was an important prognostic factor(P <0.05).In multivariate analysis clinical stage was the independent prognostic factor.Conclusion:The over-all survival rate of adenosquamous lung carcinoma was low.Stage Ⅲ may have benefit from adjuvant chemotherapy.