摘要
目的 探讨肺癌根治术后复发、转移的特点，为术后复查和治疗提供依据。方法 采用ＳＴＡＴＡ统计软件，建立病例资料数据库，并进行统计分析。生存率采用寿命表法计算，不同分组之间差异的显著性采用ｌｏｇｒａｎｋ 检验。两组间复发、转移率差异的显著性用χ２ 检验。结果 术后局部复发率鳞癌高于腺癌（ Ｐ＜ ０ ．０５） ，其他病理类型之间差异无显著性。袖式肺叶切除术、肺叶切除加邻叶部分切除术的局部复发率高于其他术式（ Ｐ＜ ０．０５） 。淋巴结转移的发生率腺癌高于鳞癌（ Ｐ＜ ０ ．０５） 。各器官血行转移发生的频率依次为：肺、骨、脑、肝、皮下及肾上腺。血行转移的发生率腺癌及大细胞癌均高于鳞癌（Ｐ＜０ ．０１） 。淋巴结转移或血行转移后积极治疗可以提高生存率（ Ｐ＜ ０ ．０１） 。结论对于跨叶性病变在肺功能许可的前提下应行多叶切除，避免做肺叶切除加受侵邻叶部分切除术。袖式肺叶切除术要尽量增加支气管切缘长度，以减少局部复发。发现淋巴结或血行转移后给予积极治疗。
Objective To study the characteristics of recurrence and metastasis following radical resection of carcinoma of the lung. Methods A total of 1 229 cases of radically resected lung cancer was statistically analyzed using STATA software. The survival rate was estimated using life table method. Comparisons of survival in each group were made according to the log rank test. The differences in rate between groups was assessed by χ 2 test. Results Recurrence rate was found higher in squamous cell carcinoma than in adenocarcinoma. It was also higher in sleeve resection and partial resection than in other resection modes ( P <0.05). The rate of lymph node metastasis was higher in adenocarcinomas than in squamous cell carcinoma ( P <0.05). Lung, bone, brain, liver, subcutis, and adrenal glands were the common resorts of metastasis, in decreasing order of frequency. Metastatic rate was the lowest in squamous cell carcinoma. Active therapy can still improve the survival even when recurrence and metastasis occurred. Conclusion It is recommended to avoid partial resection for the invaded adjacent lobe whenever patient′s condition can stand multilobectomy. It is necessary to assure resection margin length when sleeve resection is performed in order to reduce recurrence. Active therapy can improve survival of patients with recurrence and metastasis.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
1999年第4期284-286,共3页
Chinese Journal of Oncology
关键词
肺肿瘤
外科手术
术后
淋巴转移瘤
复发
Lung neoplasmas/surgery Neoplasm metastasis Lymphatic metastasis Neoplasm recurrence
