摘要
目的:探讨肺腺癌部分亚型中,单纯型细支气管肺泡癌(bronchioloalveolar carcinoma,BAC)、伴BAC成分的肺腺癌(adenocarcinoma,AC)及不伴BAC成分的AC之间的临床病理学特点及三者间的预后情况。方法:收集天津医科大学附属肿瘤医院自2004年6月至2005年12月间,经外科手术治疗及病理证实,随访资料完整并满3年的106例肺腺癌患者(男45例,女61例)的病例及相应的组织学切片。并依据2004年版WHO最新肺癌病理学分类标准进行分组:单纯型BAC、伴BAC成分的AC及不伴BAC成分的AC,运用统计学方法对三组病例的临床资料进行回顾性对比分析,同时采用Kaplan-Meier曲线描述生存率,并行Log-rank检验。结果:统计学分析表明三组间与性别、年龄皆无统计学意义,与吸烟指数、肿瘤直径、N分期、TNM分期及术后是否复发等因素有显著的统计学差异(P<0.01)。三者的3年生存率分别为96.4%、61.0%和40.5%,并且三组间有显著的统计学差异(P<0.01)。其中单纯型BAC的3年生存率高于其余两组,具有显著统计学差异(P<0.01),不伴BAC成分的AC 3年预后最差。结论:单纯型BAC、伴BAC成分的AC及不伴BAC成分的AC,三者在临床病理因素方面各有特点,并且有着完全不同的临床预后;对三者进行严格区分,可为临床提供更为可靠的治疗依据,有助于对肺腺癌患者进行科学而全面的临床治疗以及早期积极有效地评估预后。
Objective： To investigate clinicopathologic and prognostic factors of the subtypes of lung adenocarcinoma, including pure bronchioloalveolar carcinoma （BAC）, adenocarcinoma （AC） with a BAC component and AC without a BAC component. Methods： One hundred and six adenocarcinoma specimens from 106 patients （45 males and 61 females） followed up for 3 years were obtained. These patients underwent surgical resection and were pathologically confirmed as pulmonary adenocarcinoma in our hospital between June 2004 and December 2005. According to the recent 2004 World Health Organization （WHO） pathological classification criteria for lung cancer, lung adenocarcinomas were divided into three subgroups： pure BAC, AC with a BAC component and AC without a BAC component. SPSS statistical analysis software was used and Kaplan-Meier survival curves were constructed. We also conducted a Log-rank test. Results： The statistical analysis showed that no significant difference was found among the 3 groups in patient gender or age, but smoking, tumor size, N stage, TNM stage, postoperative recurrence and metastasis were significantly different among the three groups （P〈0.01）. The 3-year survival rate was 96.4% for pure BAC, 61.0% forAC with a BAC component, and 40.5% forAC without a BAC component, with a significant difference. The 3-year survival rate was significantly higher in patients with pure BAC than in patients with other types of lung adenocarcinoma （P〈0.01）. In contrast to the other two groups, the 3-year prognosis of lung adenocarcinoma without a BAC component was the worst. Conclusion： The three groups have their own distinct clinicopathologic features and different clinical prognoses. Strict distinction of the lung adenocarcinoma subtypes from the other subtypes can provide a more reliable basis for deciding upon the optimal clinical treatment and it may assist in the assessment of clinical prognosis.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第15期841-844,共4页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金资助(编号:30770828)~~
关键词
肺肿瘤
腺癌
细支气管肺泡
预后
Lung cancer
Adenocarcinoma
Bronchiolo-alveolar
Prognosis
