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多发肺结节外科治疗近期疗效的单中心回顾性研究

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目的 总结分析多发肺结节(multiple pulmonary nodules,MPNs)的临床诊断、外科治疗及预后.方法 回顾性收集2018-2020年于四川省肿瘤医院胸外科行手术治疗MPNs患者的临床资料,分析MPNs患者外科治疗的近期疗效.结果 共纳入97例患者,其中男30例、女67例,平均发病年龄(56.1±10.0)岁.双发病灶患者62例,三发病灶22例,四发病灶4例,四发以上病灶9例.手术共处理213枚高危病灶,其中磨玻璃结节88枚,部分实性结节81枚,实性结节7枚.87例行同期手术,10例分期手术,平均手术间隔时间为5.2个月.病理组合类型包括腺癌-腺癌96例(99.0%),鳞状细胞癌(鳞癌)-鳞癌1例(1.0%),淋巴结均未查见转移.2年无病生存(disease-free survival,DFS)率为92.1%,总生存率为100.0%.单因素分析显示,高危病灶直径>2 cm(P=0.316)、有无残余病灶(P=0.782)及病理组合类型(P=0.913)对2年DFS率的影响无统计学意义.结论 MPNs以多原发肺癌为主要诊断,病理组合类型以腺癌-腺癌多见,影像学检查结合病理结果对MPNs手术方案选择、诊断及鉴别诊断有重要帮助,术中应以最大限度保留肺功能和尽可能完整切除高危结节为原则,其预后相对良好.
Short-term efficacy of surgical treatment for multiple pulmonary nodules:A retrospective study in a single center
Objective To summarize and analyze the clinical diagnosis,surgical treatment and prognosis of multiple pulmonary nodules(MPNs).Methods The clinical data of lung cancer patients who received surgical treatment in our hospital from 2018 to 2020 were collected.The short-term efficacy of surgical treatment for MPNs was analyzed.Results A total of 97 patients were enrolled,including 30 males and 67 females with an average age of 56.1±10.0 years at onset ill.There were 62 patients with double lesions,22 patients with three lesions,4 patients with four lesions,and 9 patients with more than four lesions.A total of 213 lesions were surgically treated,including 88 pure ground-glass nodules,81 partially solid nodules,and 7 solid nodules.There were 87 simultaneous surgeries and 10 staged surgeries,with an average operation interval of 5.2 months.The pathological combination type included adenocarcinoma-adenocarcinoma in 96(99.0%)patients,squamous cell carcinoma-squamous cell carcinoma in 1(1.0%)patient,and no lymph node metastasis was found.The 2-year disease-free survival(DFS)rate was 92.1%,and the overall survival(OS)rate was 100.0%.Univariate analysis showed that high-risk lesion size>2 cm(P=0.316),residual lesions(P=0.782)and pathological combination type(P=0.913)had statistical effect on the 2-year DFS rate.Conclusion MPNs are mainly diagnosed with multiple primary lung cancers,and the pathological combination is mostly adenocarcinoma-adenocarcinoma combination.Imaging examination is of great help to the surgical approach selection,diagnosis and differential diagnosis of MPNs.During the operation,maximal preservation of lung function and complete resection of high-risk nodules should be taken as the principle,and the prognosis is satisfactory.

Multiple pulmonary nodulesvideo-assisted thoracoscopic surgeryprognosissurgical treatment

张崎、郭玲、高心、谢少华、李强、庄翔、向润

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电子科技大学医学院四川省肿瘤医院四川省肿瘤研究所四川省癌症防治中心胸外科(成都 610041)

自贡市第三人民医院胸外科(四川自贡 643020)

多发肺结节 胸腔镜手术 预后 外科治疗

成都市重大科技应用示范项目白求恩公益基金会

2019-YF09-00234-SNCESS2021TC01

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(2)
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