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目的 :探讨影响细支气管肺泡癌 (Bronchioloalveolarcarcinoma ,BAC)患者预后的因素。方法 :用回顾性研究方法对随访到下落且资料完整可用于分析的BAC患者 5 9例 ,按首次就诊时有无临床症状、影像学分型、TNM分期和手术是否为根治性切除等四种分类方法进行分组配对 ,先用 χ2 检验最后用Cox模型分析处理各组数据。结果 :5 9例患者的 5年总生存率为 (18/ 5 9) 30 5 % ;首诊无和有症状者 5年生存率分别为 (13/ 2 3) 5 6 5 %和 (5 / 36 )13 8% ,两者间有显著性差别 ,P <0 0 0 5 ;按影像学分类结节肿块型、肺炎型和弥漫型者的 5年生存率分别为 (16 /41) 39 0 %、(2 / 14) 14 3%和 (0 / 4) 0 ,P <0 0 0 5 ;按TNM分期Ⅰ、Ⅱ和Ⅲ期患者的 5年生存率分别为 (15 / 2 6 )5 7 7%、(2 / 11) 18 2 %和 (1/ 13) 7 7% ,P <0 0 0 5 ;接受了根治性手术和未接受根治术者的 5年生存率分别为 (18/41) 4 3 9%和 (0 / 12 ) 0 ,P <0 0 2 5。但接受根治术者手术范围差别不影响生存率 ,P >0 0 5。结论 :影响BAC 5年生存率的主要因素有患者首次诊断时有无临床症状、肺部影像学表现、TNM分期和手术是否彻底切除病灶等。只要手术能达根治 ,手术范围一般不影响预后。
Objective: To explore the factors affecting the prognosis of patients with bronchioloalveolar carcinoma (BAC). METHODS: Retrospective study was performed on 49 patients with BAC who were followed up until the date of their incompleteness and data were available for analysis. According to whether there were clinical symptoms, imaging classification, TNM staging, and whether the surgery was radical resection, there were 4 classifications. The methods were grouped and paired. The χ2 test was used first, and the data of each group was analyzed and processed using the Cox model. Results: The 5-year overall survival rate of 5 9 patients was (18/ 5 9) 30 5 %; the 5-year survival rate of first-time attendance-free and symptomatic patients was (13 / 2 3) 5 6 5 % and (5 / 36) 138%, there was a significant difference between the two, P <0 0 5; According to imaging classification nodular, pneumonic and diffuse 5-year survival rates were (16 / 41) 39 0 %, (2 / 14) 14 3% and (0 / 4) 0, P <0 0 05; 5-year survival rates for patients with TNM stage I, II, and III were (15 / 2 6) 5 7 7%, (2 / 11) 18 2% and (1/ 13) 7 7%, P <0 0 5 ; 5-year survival rates for patients who underwent radical surgery and who had not undergone radical surgery were (18/41). ) 4 3 9% and (0 / 12) 0, P <0 0 2 5. However, the difference in the range of surgery for patients undergoing radical surgery did not affect the survival rate, P > 0 05. Conclusion : The main factors affecting the 5-year survival rate of BAC include the presence or absence of clinical symptoms, lung imaging findings, TNM staging, and complete surgical resection of lesions. As long as surgery can be cured, the range of surgery does not generally affect the prognosis.